Transcutaneous electrical acustimulation (TEA) combines the technical features of acupuncture and transcutaneous electrical nerve stimulation. It delivers therapeutic electrical stimulation via surface electrodes applied to acupoints adjacent to or overlapping with nerves. This technique offers advantages such as adjustable parameters, flexible acupoint selection protocols, non-invasiveness, safety, and high patient compliance. Current research robustly demonstrates TEA's significant potential in perioperative management: it effectively stabilizes preoperative patient status, maintains intraoperative hemodynamic stability, and reduces the risk of postoperative complications. Its mechanisms of action involve autonomic nervous system balance, hormone regulation, and immune function enhancement. This review summarizes recent advances in the perioperative applications of TEA and their underlying mechanisms.