This chapter explores the diverse effects of anesthetics on the central nervous system (CNS), focusing on their pharmacodynamics and pharmacokinetics. Key topics include inhalation anesthetics, intravenous anesthetics, intrathecal techniques, and adjunctive drugs. The discussion highlights the mechanisms by which these agents impact cerebral blood flow, metabolism, and neuronal activity. Specific anesthetics such as nitrous oxide, halothane, propofol, ketamine, and dexmedetomidine are analyzed for their roles in anesthesia induction, maintenance, and recovery, with attention to their neuroprotective and neurotoxic effects. The chapter also delves into the implications for managing intracranial pressure and cerebral autoregulation in neurosurgical settings.