The management of cardiologic patients who are presenting for diagnostic and theurapeutic cardiac interventions has become a significant topic of interest and concern among anesthesiologists. This review will update recent reports and also will provide practical advice on delivering anesthesia in cardiac catheterization laboratory. During recent years cardiac procedures are more complex, take longer, and involve high risk patients. Many of these cases require general anesthesia rather than sedation. The anesthesiologist has to be familiar with advanced hemodynamic monitoring and also has to be aware of pitfalls and complications of the interventional procedures. In this new and changing arena, collaboration and planning between cardiologists and anesthesiologists are required for both patient safety and procedural success.