Multimodal prehabilitation didn’t show significant benefits for postoperative outcomes in a diverse surgical population.

• No notable reduction in major complications (adjusted risk ratio 1.02) or length of stay (adjusted incidence rate ratio 1.04).
• In high-risk GI oncological surgery patients, a non-significant 9% reduction in complications was observed.

Surgeons should consider targeted prehabilitation for high-risk patients, as broader implementations may be ineffective.