Patients undergoing major abdominal surgery, especially upper abdominal surgery, are predisposed to postoperative pulmonary complications. By optimizing physical, nutritional, psychiatric and/or other comorbid conditions of a patient undergoing surgery, a process called prehabilitation, it may be possible to reduce complications. We will review randomized controlled trials of upper abdominal procedures such as pancreas surgery to assess impact on outcomes, with an emphasis on multiple modes of prehabilitation and on pulmonary outcomes, since these surgeries can make deep breathing painful.