To discuss the recent advances in sedation and anesthesia for the practice of both flexible and rigid bronchoscopy, which are increasingly performed outside of the operating room by interventional pulmonologists and thoracic surgeons.Studies have recently documented the advantages of pharmacological sedatives and anesthetics for use in bronchoscopy. In particular, we review the increasing body of literature highlighting the advantages and benefits of propofol anesthesia for both flexible and rigid bronchoscopy.As our practice expands, relocation of appropriately triaged pulmonary interventional procedures including rigid bronchoscopy that were previously assigned to a traditional operating room setting improves provider flexibility, presents more cost-effective options while maintaining patient safety and satisfaction and reducing the time to recovery. Anesthesia practice has, therefore, shifted to caring for these sick patients outside the operating room and increasingly cooperation between anesthesiologist and proceduralist is required.