General anesthesia (GA) remains the working horse of anesthesiology, enabling surgery across every specialty. It is characterized by a reversible state of unconsciousness, amnesia, analgesia, and immobility, often accompanied by attenuation of autonomic responses. Successful anesthetic care requires careful orchestration of induction, maintenance, and emergence, while anticipating patient-specific comorbidities, surgical complexity, and intraoperative physiological perturbations. Indications for GA include cases not amenable to regional or local techniques, surgeries requiring absolute immobility, airway control, or patient amnesia, and those associated with severe physiological stress. Airway management options include supraglottic devices such as the laryngeal mask airway and definitive approaches such as endotracheal intubation. Each carries advantages and limitations that guide case-specific selection. GA requires continuous vigilance and monitoring. Standard ASA monitors are universally applied, while select procedures demand advanced techniques such as invasive arterial pressure monitoring, central venous catheters, pulmonary artery catheters, near-infrared spectroscopy, somatosensory/motor evoked potentials, processed Electroencephalogram (EEG) Bispectral index (BIS), and transesophageal echocardiography. The anesthesiologist must integrate anesthetic depth with surgical needs, neuromonitoring requirements, and patient safety. This chapter reviews the principles of induction, maintenance, and emergence, indications for GA, choice of airway devices, physiologic considerations, and advanced monitoring techniques. Emphasis is placed on understanding the anesthetic implications of special monitoring (e.g., neuromonitoring interactions with anesthetics and hemodynamic goals in cardiac or neurosurgery). For internists, appreciating these principles clarifies perioperative decision-making, postoperative complications, and collaborative management.