Many intracranial vascular pathologies are now being successfully managed by interventional neuroradiology techniques. The procedures have become increasingly complex, requiring planning and coordination. Key roles are played by the anesthesiologist and close collaboration with neuroradiologist is crucial for successful results. The optimal conduct of anesthesia in a neuroradiology suite requires careful planning of each procedure and detailed evaluation of the individual patient. The basic principles of neuroanesthesia cannot be avoided: optimization of cerebral blood flow, perfusion pressure, control of intracranial pressure and close monitoring of hemodynamic values, respiratory patterns, fluid status and body temperature are all necessary. Rapid awakening must be ensured so that the patient’s neurological status can be assessed quickly. The provision of anesthesia outside the operating room has its own inherent risks. This chapter will focus on perioperative anesthesiologic care and strategies to avoid or deal with complications if they do occur.