All commonly used anesthetic agents and drugs undergo placental transfer. Understanding the placental transfer of anesthetic drugs and their effects on the neonate is essential for optimal administration of both regional and general anesthesia. Regional anesthesia is decidedly safer for the mother and, when properly performed, actually may be beneficial to the stressed neonate. The healthy neonate also benefits from maternal analgesia during labor and delivery. General anesthesia may result in transient neonatal depression, particularly when delivery is of an emergency nature. The skill and knowledge of the anesthesiologist are more important than the type of anesthesia administered. Therefore, when properly performed, both regional and general anesthesia are quite safe in terms of neonatal outcome.