Pre-test assessment describes the next step after deciding to do a cardiopulmonary exercise test (CPET). The indication for the test must be defined, with clear end points. A CPET is a very safe test. There are well-defined conditions which increase the risk. The most serious side effects are related to heart problems, most commonly seen in subjects with unstable heart disease. Careful scrutiny of the resting electrocardiogram (ECG) is imperative prior to the test. If the subject is unwell, e.g. with a viral illness or an exacerbation of asthma, the test should be postponed. On the day of the test, the subject should take their usual medication. Caffeine and alcohol should be avoided on the day of a CPET. A light meal should be taken at least 30 minutes beforehand.