Anesthetics are widely used in clinical practice to ensure safe anesthesia and enable surgical procedures, as well as for sedating patients in intensive care units. This chapter examines the cardiotoxic effects of intravenous, inhalational, and local anesthetics, focusing on their mechanisms of action and associated risks. While their cardioprotective actions are often highlighted, certain clinical conditions reveal their potential for cardiotoxicity. Intravenous anesthetics like propofol may cause hypotension, myocardial depression, and, in rare cases, propofol infusion syndrome, while ketamine’s sympathomimetic effects increase blood pressure and cardiac output, posing risks for patients with cardiovascular disease. Both can affect mitochondrial function and the cardiovascular system. Inhalational anesthetics, such as sevoflurane, isoflurane, and desflurane, have varied effects: sevoflurane reduces cardiac contractility, whereas isoflurane and desflurane are linked to oxidative stress and DNA damage. Local anesthetics, including lidocaine, bupivacaine, and ropivacaine, block sodium channels but at high doses may cause severe cardiovascular reactions, such as arrhythmias and reduced contractility. Monitoring hemodynamic parameters is crucial when using these anesthetics, particularly in patients with compromised cardiovascular functions. This chapter underscores the importance of dose adjustment, risk identification, and further research to minimize toxic effects, enhancing patient safety in anesthesiology practice.