In this chapter, we will present the essentials of pre-sedation screening and risk stratification, discuss fasting guidelines, and review the most commonly encountered scenarios and comorbidities that impact sedation management and outcomes. Today’s practice of pediatric sedation (PS) involves ever more complex patients whose care is coordinated with multidisciplinary teams. Technological advances have allowed for the development of various invasive and noninvasive pediatric procedures and imaging modalities, resulting in a tremendous demand for and growth in PS in children. Despite the increasing complexity and patient volume, sedation providers generally meet the child and their family only minutes before the scheduled (or unscheduled) procedure. The provider must assess the situation quickly and accurately to ensure safety and optimal effectiveness. Important data from all available resources should be gathered and synthesized before the procedure to formulate a successful sedation plan within the context of the urgency of the procedure.