Objective To evaluate the application effect of a preoperative five-component prehabilitation program in patients undergoing cardiac valve surgery. Methods A cluster-randomized control trial was designed, and a total of 67 patients scheduled for elective cardiac valve replacement surgery were divided into a control group (n=33) and an intervention group (n=34). The control group received routine perioperative care, while the intervention group additionally received a five-component prehabilitation program from admission until surgery, including nutritional support, exercise training, psychological intervention, medication optimization and respiratory muscle training. Results Compared with the control group, the intervention group demonstrated significantly greater improvements in 6-minute walking distance, maximal inspiratory pressure, and health-related quality of life scores at discharge, and it had significantly shorter total postoperative hospital stays and ICU stays (all P<0.05). Conclusion The preope-rative five-component prehabilitation program effectively enhances postoperative physical function, respiratory performance and quality of life, while reduces hospitalization duration in cardiac valve surgery patients.