An increasing number of obese patients in the operating room is inevitable due to the well-known associated chronic health problems such as cardiovascular disease, diabetes mellitus, arthritis and cancer. Further, bariatric surgery is also likely to be increasingly performed. This article discusses the intraoperative issues in the care of patients with obesity, including airway management, pharmacokinetics, perioperative positioning, regional anesthesia, the intensity of monitoring required, laparoscopy, and minimizing hypoxia during anesthesia.