Performing an anesthetic in a procedure suite instead of in the operating room can be extremely challenging for the anesthetist. Not only are the procedures performed outside of the operating room becoming increasingly more complex but also patient acuity is increasing. In some cases, the out-of-operating room procedure may be selected as a less risky alternative to an operating room procedure in an extremely high-risk patient. Effective preprocedure evaluation and preparation are critical to achieve optimal clinical outcomes and maximal operational efficiency in these areas.