Determining if bariatric surgery is the right course of action for a patient is important. Qualifications for bariatric surgery have changed over the past several years. A multidisciplinary team is often utilized to optimize patients for bariatric surgery and to determine their candidacy. The team is often comprised of a bariatric surgeon, psychologist, nutritionist, internist, and can also include other specialities like endocrinology, physical therapy, and plastic surgery. Pre-operative evaluation by anesthesia is also often performed to ensure patient safety during bariatric surgery. Anesthetic special considerations include airway management, anesthetic agent selection, medical optimization, pulmonary function, induction, fluid administration, and positioning. A thorough pre-operative evaluation by a multidisciplinary team is essential to ensure bariatric surgery safety and efficacy.