Recent statistics indicate that the obesity rate exceeds 35% in 5 states and 30% in 25 states in the United States. As the prevalence of obesity continues to increase, the number of bariatric and nonbariatric surgeries in this patient population also continues to grow. As such, anesthesia providers must be cognizant of some special considerations pertaining to surgery and anesthesia for the obese patient. Overall, surgery on obese patients is considered higher risk than in nonobese patients, and targeted perioperative assessment and planning are crucial for reducing morbidity and mortality. Obesity results in alterations in physiology, and these effects are seen within all major organ systems. Extra consideration should be dedicated not only to the preoperative airway evaluation but also to logistic issues that may arise. To this end, it is crucial that the operating room be equipped with size-appropriate equipment as well as allowing for adequate time to move, position, and induce obese patients. Intraoperative concerns due to obesity include appropriate drug dosing, choice of anesthetic, and the cardiopulmonary impact of the anesthetic. Postoperative concerns include pain control, pulmonary hygiene maneuvers, as well as continued management of comorbid conditions. These alterations and their impact on the perioperative care of an obese patient at various points of perioperative care are herein reviewed. This review contains 2 figures, 5 tables and 36 references Key Words: airway evaluation, body mass index, drug dosing, morbid obesity, obesity hypoventilation syndrome, preoperative evaluation, rapid desaturation, sleep apnea evaluation, surgical risk evaluation