Perioperative pain management requires a multifaceted approach. The local inflammatory injury and the local and centrally mediated responses must be understood and evaluated to be treated appropriately. This article reviews the different classes of medication and where each one fits into a pain management plan. The implementation of multimodal therapy, which combines different techniques, routes of administration, and different drugs, must be managed. Our ultimate goals are to provide safe and effective pain management, reduce adverse outcomes, preserve patients' physical and psychological well-being, and improve the quality of life for patients with acute pain during the perioperative period.