Obesity, the most common nutritional disorder in the United States, has taken on epidemic proportions, spreading rapidly during the 1990s across all states, regions, and demographic groups in the United States, according to the CDC. The presence of coexisting disease, difficulty with airway management and respiratory compromise, as well as alterations in drug metabolism in obese patients, combine to make understanding this particular disorder vital for the clinical anesthesiologist. This review summarizes the clinical presentation, pathophysiology, and treatment of morbid obesity. Preoperative assessment, intraoperative management, and postoperative care, as well as anesthetic management of coexisting disease states of obesity are addressed.