Background Continuous perioperative monitoring of vital signs using wearable devices could allow for early detection of physiological deterioration, enabling more timely treatment of potential complications. This study aimed to assess the feasibility and accuracy of the Zephyr Biopatch wearable device perioperatively. Methods General surgical patients were eligible for inclusion in this prospective observational study. Accuracy of the wearable was assessed via Bland-Altman and Clarke-Error grid analysis compared with nurse assessments as the reference standard. Patient reported usability was also assessed through scales and questionnaires. Results 14 patients were recruited, and 10 patients completed the study. Mean duration of recording per patient was 21.4 hours preoperatively and 43 hours postoperatively. Chest-based measurements were accurate but imprecise for heart rate (HR), respiratory rate (RR), and inaccurate and imprecise for core temperature measurements. On Clarke-Error grid analysis, 100%, 98.6%, and 99.3% of HR, RR and temperature measurements resulted in the same clinical action being taken based on the Early Warning Scores they produced, compared to the nurse measurements. Patients reported a System Usability Scale score of 79 and a satisfaction score of 4.4 (out of five). Conclusion Continuous perioperative monitoring of HR, RR and core temperature through the chest-based Zephyr device after major abdominal surgery is feasible and acceptable. However, further work on wearable accuracy and implementation strategies are needed before devices can used to supplement clinical care.