At a preoperative evaluation for skin grafting surgery, a man's prescription medications were reviewed and updated in his medical record. During surgery, the patient experienced profuse bleeding, requiring transfusion with multiple units of blood. Postoperatively, the patient stabilized and the attending surgeon reexamined the patient's medications with him and asked about over-the-counter medications. The patient had been taking one aspirin per day, including the day of surgery. Although the patient was asked about blood-thinning medications at the preoperative visit, he was not asked about over-the-counter medications. In the accompanying commentary, Varalakshmi Janamanchi, MD; Kunjam Modha, MD; and Christopher Whinney, MD, all of Cleveland Clinic Lerner College of Medicine, emphasize the importance of accurate preoperative medication reconciliation and recommend improvement strategies such as physician–pharmacist collaboration and training providers to ask patients specifically about over-the-counter medications.