Postoperative delirium (POD) is widely accepted as a topic of important medical and public health relevance, which can usually be prevented through comprehensive perioperative management. The update to the 2017 ESAIC guidelines on the prevention of POD is based on evidence and consensus, referencing research on adult POD prevention, treatment, and care published between 01 April 2015,and 28 February 2022, to provide updates and recommendations on basic science, risk factors, preventive measures, neuromonitoring, treatment and POD outcomes.