The intense care units (ICUs) of postoperative care are important in the surgical result, especially of patients who are at high risk during their major or complex surgical operations. Fluctuation in monitoring of the postoperative care, pain management, prevention of infection and management of complications has been a source of preventable morbidity, extended ICU care, and higher healthcare expenditure in the past. Evidence based protocols have become one of the foundations of contemporary postoperative intensive care, and they are expected to standardise practise, enhance compliance with the optimal evidence, and promote patient protection. This article is a review of evidence-based protocols in postoperative intensive care, which summarises the results of randomised trials, implementation studies, clinical recommendations, and quality improvement programmes. The important areas explored are postoperative monitoring, pain management, prevention of pulmonary complications, sepsis management, prevention of delirium, glycemic control, handover communication, physiotherapy, and enhanced recovery pathways. Another area that the article discusses is the issues of the implementation, the use of the checklists and the digital tools, as well as the incorporation of the psychosocial and the public health views. New trends in precision medicine, artificial intelligence, and patient engagement are talked about. The review answers that an evidenced-based approach of implementation of postoperative ICU protocols can lead to better clinical outcomes, workflow, and patient-centred care.