Preoperative routine tests are widely prescribed in clinical settings. However, these tests do not help improving the quality of medical care in low-risk elective surgery. Instead, they are associated with lower efficiency and increasing fees. To improve the efficiency, many regions, institutions, and scholars have attempted to reduce preoperative routine tests without indications through propaganda, education, consensus, and guidelines. Nevertheless, the effects are still highly dependent on the expertise and emphasis of practitioners. Machine learning based on big data provide a new solution with its standardization and automation. Through literature review, we extracted the big data, including demographic features such as sex and age, histories including diagnosis and chronic diseases, and physical examination features such as visual function and body mass index. A total of 34 000 patients undergone ocular surgeries in Zhongshan Ophthalmic Center, Sun Yat-sen university from 2017 to 2019. Machine learning was adopted to predict the risk of finding abnormalities in chest X-ray examination, with an accuracy of 81.2%. Area under the Receiver Operating Characteristic curve was 0.864. The study could be an early exploration into the field of simplifying preoperative tests by machine learning.