Postoperative pyrexia refers to an elevated body temperature greater than 38.0°C following surgery. About 40% of patients develop pyrexia after surgery, though most cases have no identifiable cause. It is important to evaluate febrile postoperative patients to identify potential infections or other treatable causes. The approach involves considering the timing of fever onset, degree of fever, accompanying symptoms, and performing a physical exam, infection screening tests, and monitoring to guide management and treatment of the underlying cause.