The number of non-operating room anesthesia (NORA) procedures continues to increase rapidly. Ongoing technological advancements and innovations in percutaneous image-guided procedures have continued to rapidly evolve. As a result, procedures have become more technically complex. This has been paired with innovations in anesthetic care for complex cases such as advanced ventilation techniques. NORA locations typically include the following suites: interventional radiology (IR), diagnostic radiology (magnetic resonance imaging [MRI] and computed tomography [CT]), electrophysiology, and endoscopy. Although the same principles and considerations apply to patients who have monitored anesthesia care (MAC) or general anesthesia (GA) outside of the main operating room, this increase in cases is accompanied by an increase of oversight in safety in these remote locations. Three distinctive features characterize NORA: location, operator, and distinctive novelty. Factors relating to ergonomics, lack of anesthesia resources and personnel, and lack of familiarity with the environment are perhaps the biggest and most underestimated considerations. Considering these factors, team communication is paramount as is having a plan for crisis management with appropriate anesthesia equipment to promote patient safety and procedural success.