Perioperative anesthesia care for the patients undergoing ophthalmologic procedures is unique and sometimes challenging. Many of the ophthalmologic procedures can often be done with sedation/monitored anesthesia care (MAC) [1]. Intravenous sedatives combined with topical/local/regional anesthesia during eye surgery can alleviate patients’ pain, fear, anxiety, thus improving outcomes [2]. In this chapter we review the current practices and trends in anesthesia service with respect to MAC for ophthalmologic procedures with topical/local/regional anesthesia [1, 2, 3]. The nerve blocks performed for eye surgery determine, to some extent, the techniques and requirement of the sedation level by the anesthesia service. And the traditions of surgery teams and hospitals also affect the choice of sedation technique. The evolvement of surgical techniques seems to facilitate the trend that sedation is more and more used in the eye surgical procedures. Anesthesia care options are also based on surgeons’ skill and anesthesia providers’ comfort level, and the patients’ expectations and demands. Regardless, patients’ safety and perioperative care quality are the key determinants [1, 3, 4].