In the early 1970s, laparoscopes were used primarily for diagnostic procedures and minor operative procedures. In 1987, Phillipe Mouret described the first laparoscopic cholecystectomy in France. The technique was introduced into the United States in 1988 by Reddick and Olsen. Today, due to advances in digital and fiber optic technology, newer video cameras and monitors have made it easier to perform complex surgical procedures with laparoscopes. The duration of some operative laparoscopies, the risk of unsuspected visceral injury and the difficulty in evaluating the amount of blood loss are other factors that make anesthesia for laparoscopy, a potentially high risk procedure. This chapter briefly outlines anesthesia for laparoscopic surgeries with an emphasis on gynecological procedures. The anesthetic principles discussed in this chapter can also be applied to gastrointestinal, urological and general surgical procedures done by laparoscopy. Laparoscopic procedures have become very common in gynecology. The advantages of laparoscopic surgeries compared to laparotomies are numerous. Pneumoperitoneum causes some cardiopulmonary changes and anesthesiologists should familiarize themselves with the physiological effects of these changes. Patients with preoperative compromising cardiovascular and respiratory conditions need closed monitoring. Alternate gases to CO2 like helium, argon, or nitrous oxide do not seem to reduce morbidity. Gasless laparoscopies have been tried but generally have increased technical difficulty. Unfortunately, no one anesthetic technique is clearly superior to the others. General anesthesia with controlled ventilation seems to be the safest technique for laparoscopic surgeries.