A wide array of gastrointestinal (GI) endoscopy procedures are carried out in the GI endoscopy suite. Although the screening colonoscopy is the most one widely performed procedure (greater than 14 million procedures completed per year in the United States alone), other procedures are routinely utilized to diagnose and treat various GI pathologies.1 Procedures range from minimally invasive, such as a routine screening colonoscopy, to much more invasive and complicated, such as endoscopic submucosal dissection (ESD). Sedation and anesthesia are integral parts of each GI endoscopy procedure. Adequate sedation and anesthesia optimize patient comfort and create a favorable environment for the physician to safely and efficiently carry out the necessary procedure. Understandably, levels of sedation and anesthesia vary with the invasiveness of the GI endoscopic procedure and the individual patient. Thus, cogent plans for sedation and anesthesia should be devised for each patient expecting a GI endoscopic procedure. Anesthetic considerations are discussed in detail in Chapter 16.