Thousands of children receive sedation for procedures performed outside the operating room (OR) every day. Sedation for a wide range of elective and emergent procedures is performed by an array of providers, using a variety of drugs, in many settings. The expectations for safety, efficacy, and patient/family experience with procedural sedation have evolved and become clearer over the past three decades. Large, prospective studies investigating outcomes of procedural sedation performed by dedicated, experienced providers have identified expected rates of adverse events, as well as factors that place patients at increased risk for adverse events associated with procedural sedation. The intent of this chapter is to review the current, significant, and expanding literature on procedural sedation for children performed outside the OR, examine important quality measures of sedation, and identify performance standards, expected adverse events rates, and outcomes that define best practice of sedation. We aim to review studies of the largest cohorts of patients which examine the safety, effectiveness, and quality of procedural sedation provided to children and to propose benchmarks for outcomes.