This chapter presents discussion on role of anesthesia in assisted reproductive techniques. The most common procedure during an in vitro fertilization (IVF) cycle requiring anesthesia is during oocyte retrieval. Occasionally, embryo transfer may be performed under anesthesia. Dilatation and curettage (D and C) is seldom encountered in an IVF unit. Conscious sedation (“twilight sleep”) is a specific anesthesia technique for a diagnostic or therapeutic procedure done under local anesthesia along with sedation and analgesia. It is a drug-induced depression of consciousness where the patient remains calm while she is awake and responds to verbal commands or tactile stimulation. This is the most commonly used anesthesia technique in an IVF setting. Advantage, disadvantages, complications, and monitoring of conscious sedation anesthesia are covered in this chapter. A detailed discussion on general anesthesia and regional anesthesia is also provided in this chapter.