Background: Perioperative pressure injury (PI) remains problematic. Five key pressure injury prevention (PIP) strategies were identified according to literature. However, little is known about current perioperative PIP practice in compliance to international guidelines. Methods: This study describes perioperative health care practitioners’ implementation of five key PIP strategies in compliance with international PIP guidelines in a tertiary hospital. This was achieved via observation of the implementation of PIP strategies using a structured data collection tool and skin inspection on postoperative day 2. Results: Seventy-three patients undergoing surgical procedures were recruited. Of these, 36 were identified as at-risk of developing PI based on the Waterlow risk assessment. The number of PIP strategies implemented across the sample ranged from 27 to 49 strategies; and increased according to risk, with high-risk patients receiving more PIP strategies than those patients at moderaterisk, although this finding was statistically non-significant.