The delivery of anesthesia in any setting is not without risk. The environment is complex, uncertain and ever-changing. Human performance of this potentially hazardous task can be unpredictable and imperfect, especially in times of urgency, intensity and time-pressure. Risk and Human Error cannot be eliminated. Risk and Human Error can be reduced and managed, by eliminating a culture of blame and punishment and replacing it with a culture of vigilance and cooperation to expose and remediate systems weaknesses, which, in combination, often lead to error and injury. This presentation will explore various aspects anesthetic risk identification, management and reduction.