Background: The global population is growing and living longer. We can see an increasing number of patients undergoing surgery at older ages, with increasing frailty and numbers of co-morbidities. The Geriatric Pre-Operative Service (GPS) provides a pre-operative geriatrician review for older adults due to undergo elective surgery. During the review, patients receive a Comprehensive Geriatric Assessment (CGA)—a structured evaluation of medical, cognitive, functional, and psychosocial factors—aimed to optimize perioperative management. This audit aimed to assess whether general surgery patients who were reviewed in the GPS had improved surgical outcomes compared with those receiving standard pre-operative care. Methods: A retrospective review was undertaken of 100 patients aged ≥65 years (≥60 for Aboriginal and Torres Strait Islander patients) who underwent elective general surgery (Upper GastroIntestinal, Colorectal & Hepatobiliary) between January 2024 and August 2025 under Inclusion criteria. Fifty patients attended the GPS and received CGA, while fifty underwent similar procedures without clinic review. Outcomes included hospital-acquired complications (HACs), length of stay (LOS), readmission rate and mortality. Results: The average length of stay was shorter for patients who were reviewed in the geriatric preoperative clinic (6.5 days) than those who were not (10.4 days). This difference was statistically significant with a p value= 0.0055. Patients seen in the GPS had approximately 22% lower odds of a hospital-acquired complication, but the difference is not statistically significant (p-value 0.079). The GPS cohort demonstrated reduced numbers of re-admissions to hospital, despite this there was no statistical difference between groups (P-value=0.186). Conclusion: Preoperative geriatrician review incorporating CGA was associated with a statistically significant reduction in length of hospital admission. These findings support the integration of geriatric assessment into preoperative care pathways.