Technological medical diagnosis advances in cardiology have markedly increased indications for temporary or permanent artificial cardiac pacemakers (PM). This means that, in addition to cardiologists, other specialists have become involved in the handling of these devices. When PM patients undergo surgery, anesthesiologists participation may be decisive for the success of the procedure. This review aimed at familiarizing anesthesiologists with major clinical indications and operation of these devices, as well as with PM-related pre and intraoperative cares.Classification, operation, and major clinical indications for PM implants are covered. In addition, primary PM-related pre and intraoperative cares required for success are explained.Basic understanding of PM operation and indications should be part of anesthesiologists daily practice. Hence, handling and indication of temporary PM broadens these specialists scope, in addition to saving lives in emergency situations. Electric cautery should be avoided in artificial cardiac pacemaker patients.