Do I need any fasteners to install this gasket?

Your header bolts will hold the gasket in place — those are part of your existing header assembly. This gasket ships as-is; verify you have the correct header hardware before installation.

Can I reuse the old gasket if it's still holding seal?

No. Aluminum gaskets compress permanently under heat cycling and lose sealing ability once removed. Always install new when you break the header seal.

Does this require any surface prep before install?

Clean the header mounting surface and manifold face with a wire brush to remove old gasket material and carbon buildup. Reinstall on a clean, flat surface for the best seal.