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Assessing the risk of major adverse cardiac events (MACE) before initiating aerobic exercise is vital with direct access to physical therapy (PT). While there are various methods, PT lacks a standardized approach. This scoping review yielded 1,519 articles; 35 articles met established criteria. Five methods were identified: (1) risk factor assessment (2) questionnaires (3) calculators (4) physical examinations (5) exercise testing with electrocardiogram. Risk factor assessment yielded the most statistical information regarding MACE. Risk calculators provided a clearer assessment low, medium, or high-risk categories. PTs can use these tools to assess risk and identify patients that require further evaluation.