The provision of sedation during therapeutic and diagnostic procedures in children is not without risk. Adverse events occur due to the interplay of patient, procedural, environmental, and medication characteristics. Preemptive recognition of the characteristics that may increase the risk of developing adverse events allows the practitioner to predict and prepare for such events. Early recognition can allow alteration to the sedation plan minimizing adverse events. Hence, timely recognition and effective management of adverse events are essential for successful outcomes.