The anesthetist is part of a multidisciplinary team which allows understanding of the pathogenesis of the fetal conditions and how the planned therapy may influence outcome. Two expert anesthetists should be present one for the mother and another for her baby. It is assumed that the anesthetists are familiar with routine obstetric anaesthetic considerations and those relevant to the fetal surgery were highlighted. It is essential to have good communication and cooperation between surgeons, anesthesiologists and perinatal physicians. This communication will allow development of a cohesive anesthetic and surgical plan that can be used for the safe perioperative management of the fetal surgery patient. Postoperative management includes proper tocolysis in midgestational surgeries to prevent uterine contraction and allow proper uteroplacental circulation. In contrast to that, reversal of tocolysis to prevent uterine relaxation and prevent postpartum haemorrhage should be done in EXIT procedure. Intensive care facilities for both mother and neonate must be available. Another operating room maybe needed for further neonatal surgery according to fetal anomaly. A lot of complications may meet the anesthetists working in fetal surgery for both mother and fetus including maternal haemorrhage, preterm labor, maternal pulmonary oedema, maternal and fetal cardiovascular depression and death of one or both of them.