Perioperative information management systems are used to generate the official documentation of patient care throughout the surgical experience. Successful implementation of perioperative information management systems requires a careful assessment of the contextual factors (ie, the social, cultural, and physical environment) that are present at the site. Failure to sufficiently assess these contextual factors is one of the leading causes of unsuccessful system implementation and can result in decreased patient safety, poor documentation quality, inefficient work processes, and wasted financial resources. Clearly defining and identifying the contextual factors are necessary to improve the performance and utilization of information management systems. The purpose of this article was to provide an integrative review of the empirical and theoretical literature on the contextual factors present in the perioperative environment to help guide future research and clinical practice. Specifically, this review addresses a gap in the literature regarding the descriptions of the contextual factors and how these factors affect implementation practices and system use. By clearly identifying these contextual factors and determining their relationship to successful system implementations, informatics specialists can tailor implementation and assessment tools to both patients and perioperative settings. © 2013 Wolters Kluwer Health.