This chapter focuses on anesthesia guidelines in morbidly obese patients for bariatric surgery. The incidence of obesity has more than doubled since 1980. Obesity is a multisystemic disease affecting the various organ systems such as cardiovascular, respiratory, endocrine, gastrointestinal, and hepatobiliary systems. It is second only to smoking as a preventable cause of death. Obese surgical patients are special subgroup who requires highly specialized care by a team of well-trained and experienced surgeons, anesthesiologists, and paramedical staff in order to have a favorable outcome after surgery. The aim of these guidelines is to present the current evidence based practices for providing safe anesthesia for this high risk population group. Indications for bariatric surgery, preoperative evaluation, preoperative medications and preparation, intraoperative management, and postoperative considerations are covered in this chapter.