Propofol may be used without any restriction in all cases of asymptomatic hepatic porphyria, as a bolus injection for induction and maintenance of anaesthesia and as a continuous infusion to produce anaesthesia of short and medium duration. If in doubt as to the absolute safety of propofol in case of symptomatic hepatic porphyria, preference has to be given to neuroleptanalgesia, benzodiazepines and muscle relaxants. If propofol is to be used, treatment with haematin should be readily available. In all cases, it is essential to determine porphyrins and their precursors prior to and after surgery. Urine collection should strictly adhere to the recommended procedure: sterile conditions, protected from light and high temperature. Any abnormal reaction after the administration of a drug, especially propofol, should be notified to and discussed with the National Porphyria Centre (Centre Français des Porphyries). In case of symptomatic hepatic porphyria the use of propofol should always be notified to the National and to the European Porphyria Centres (Orphan Europe).