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The increasing prevalence of cannabis use in the USA has important perioperative considerations as preoperative use may increase the risk of intraoperative complications, postoperative nausea and vomiting, severe postoperative pain and side effects associated with cannabis use cessation. 1–3 ASRA Pain Medicine consensus guidelines regarding perioperative cannabis use recommend universally screening to determine type, amount, frequency of use, route of administration and time of last use.3 In this single-institution retrospective study, we hypothesized an increasing prevalence of cannabis use self-reported preoperatively among orthopedic surgical patients in the past 5 years.