The American College of Obstetricians and Gynecologists Presidential Task Force on Patient Safety in the Office Setting was convened to identify patient safety concerns, develop tools, and provide guidance for physicians performing invasive surgical procedures in the office setting. Physicians who serve as office medical directors have a myriad of responsibilities related to clinical and patient safety, including evaluating staff competency, encouraging office team communication, promoting patient partnership, and ensuring safety in the use of analgesia or anesthesia. Activities and tools used in the inpatient setting, such as multidisciplinary team meetings, checklists, time-outs, mock emergency drills, and measurement and reporting systems, can easily be tailored and applied to any office practice.