Purpose The PRIORITY TRIAL is a multi-centre randomised controlled trial investigating the effectiveness of a preoperative exercise and education program compared to standard of care on postoperative complications of patients undergoing major gastrointestinal cancer surgery. Methodology 207 participants from the Royal Prince Alfred Hospital, Chris O’Brien Lifehouse, and Peter MacCallum Cancer Centre will be recruited. Adult patients scheduled for pelvic exenteration, cytoreduction, oesophagectomy, pancreatectomy, hepatectomy or gastrectomy surgery for cancer are eligible.. Patients will be randomised into either the preoperative exercise and education program or standard care group. The intervention will be delivered by community physiotherapists or exercise physiologists and composed of an exercise and education program for 4-8 weeks before surgery. Primary outcome is postoperative complication rate. Secondary outcomes include length of intensive care unit and hospital stay, quality of life, postoperative morbidity, and costs. Results The trial started recruitment in 2021, with 201 patients recruited to date. These include 107 (53%) females and 94 (47%) men, with an average age of 58 (26-79). 114 (57%) patients underwent Cytoreduction surgery, 39 (19%) Pelvic Exenteration, and 48 (24%) upper gastrointestinal cancer procedures. Recruitment is expected to be completed by February 2024, and follow-up by July 2024. Conclusion The PRIORITY TRIAL will determine the effectiveness of an individualised, preoperative exercise program and education before surgery for patients undergoing major gastrointestinal cancer surgery. We hypothesise that the intervention will be effective in improving postoperative outcomes and cost effective.