Circulatory collapse and the need for cardiopulmonary resuscitation (CPR) is one of the more stressful crises that can occur in the operating room (OR). In such an emergency, it is the responsibility of the anesthesiologist to swiftly recognize and intervene to ensure recovery of spontaneous circulation (ROSC) without further injury. Success requires the necessary reflexive clinical skills, awareness of surrounding equipment, understanding of reversible etiologies, appropriate task delegation, and a composed demeanor. Fortunately, intraoperative cardiac arrest in noncardiac surgery is rare (1-7 cases per 10,000, ∼40% 30-day survival) and an OR serves as an almost ideal location for such an event given its advanced monitoring, immediate medication availability, proximity to invasive line equipment, airway management tools, and pacemaking/defibrillation equipment. In addition, timely access to advanced imaging and treatment modalities such as transthoracic and transesophageal echocardiography, extracorporeal membrane oxygenation (ECMO), and cardiac catheterization (for example, emergent coronary stent, thrombectomy, intraaortic balloon pump) enhances the likelihood of a successful outcome.