High-risk patients under surgery or ICU care are the area of focus for critical care anesthesia. High-level monitoring, ventilatory support, and hemodynamic stabilization are the hallmarks to maintain safety and stability during the perioperative phase. Interdisciplinary cooperation among intensivists, anesthesiologists, and surgical teams is mandatory to deal with complicated cases. Pharmacological advancements, monitoring modalities, and perioperative pathways improve outcomes and survival rates in critically ill patients.