Orthotopic liver transplantation (OLT) is the only definitive therapy for most forms of acute and chronic hepatic failure. The first successful orthotopic liver transplant was performed by Starzl in 1963. Liver transplantation is a complex surgical procedure which entails replacement of unhealthy liver with a new liver allograft. This surgical procedure is now widely common all over the world in various medical centers. Cirrhotic disease, cholestatic disease, acute hepatic failure and metabolic disease are the indications for orthotopic liver transplantation. Living donors and brain-dead donors are anesthetic management of donor. General core, respiratory, cardiovascular, fluids and nutrition, blood and coagulation, systemic effects and investigations are the principles of donor management. The main focus of this chapter is on anesthetic management of donor and anesthetic management of the recipients including preoperative evaluation and optimization, intraoperative management, early-extubation (fast-tracking), postoperative care and postoperative adverse events.