Proper anesthetic management of IHD patients undergoingnoncardiac surgery needs careful preoperative evaluation of the patientwhich involves risk stratification, evaluation of functional capacity, andevaluation of the surgical intervention which includes the urgency of theoperation and the surgical risk.Some patients may need further diagnostic interventions (such asstress ECG, DSE and Radionuclide myocardial perfusion imaging) andtherapeutic procedures (such CABG and PCI with or without stents).The decision to stop or continue antiplatelet therapy with aspirinwith or without clopidogrel should be weighed carefully and discussedwith the surgeon, cardiologists, and anesthesiologist so as to avoid majorintraoperative bleeding and in the same time avoid the risk of stoppage ofantiplatelet drugs especially in patients with Drug Eluting Stents.Patients receiving perioperative Beta Blockers, Alpha-2 agonists,and Statins have shown significant decrease in cardiac events whichinclude AMI and cardiac death.Avoiding perioperative tachycardia by the use of beta blockers andclonidine and also by achieving proper depth of anesthesia is moreimportant than choice of the anesthetic technique and anesthetic agent.Monitored anesthesia care was proved to have the highest incidence ofpostoperative cardiac events in IHD patients while no difference betweengeneral and regional anesthetic techniques.Perioperative pain management, perioperative control of bloodglucose, avoidance of anemia (hematocrit 28-30%), and avoidance ofhypothermia are important aspects of perioperative management of IHDpatients undergoing noncardiac surgery.