Recent advances in anesthetic and surgical techniques have resulted in an ever-increasing number of surgical procedures being performed on a day-case basis worldwide. The cost-effectiveness of day-case surgery is well recognized. Day-case surgery constituted 60–70% of all surgery performed in North America in the 1990s but in other parts of the world, the numbers are lower. However, as outcome data become available confirming the safety of day-case surgery, it is anticipated that even more procedures will be performed on a day-case basis. Major advances in anesthetic techniques include the use of anesthetic agents of short duration and increasing use of regional anesthetic techniques. Most day-case surgery procedures are associated with relatively minor surgical trauma, so discharge of these patients frequently depends on recovery from anesthesia. Top priorities for successful outpatient surgery are the four ‘A’s: alertness, ambulation, analgesia and alimentation. Excessive fatigue, nausea, vomiting or unrelieved pain will delay discharge; these symptoms are the most common reasons for unanticipated hospital admission. Rapid recovery after the use of new, short-acting anesthetic agents has led to the concept of fast-tracking and by-passing the post-anesthetic care unit (PACU).