BACKGROUND: Perioperative patient health literacy influences postoperative recovery and self-management. We conducted a cross-sectional study to determine perioperative patient health literacy levels and associated factors. METHODS: From August 2021 to January 2022, 187 patients undergoing surgery at an acute care hospital completed a self-administered questionnaire, based on the Functional, Communicative and Critical Health Literacy (FCCHL) scale, to assess health literacy and related factors. Multiple regression analysis was conducted to identify factors associated with health literacy. RESULTS: Out of 316 surveyed patients, 187 were included in the analysis. Over 70% of perioperative patients in this study were classified as having limited health literacy according to the FCCHL scale. These patients exhibited low communicative and critical health literacy. Factors significantly associated with patients' total health literacy scores included age, knowledge about diseases, education level, use of media about health and disease, and generalized self-efficacy. CONCLUSION: Healthcare providers should recognize that perioperative patients generally possess low health literacy. Understanding factors influencing individual health literacy levels is essential to provide tailored support in the perioperative patient.