Pharmaceutical services in surgery and anesthesiology should be the standard of practice in health care organizations across the United States. Although not essential, an onsite satellite pharmacy would help in the provision of these services. A majority of distribution-related activities should be done by technicians. The availability of automated devices and other technology may lessen, to some extent, the time devoted to drug distribution. It is important for the OR pharmacist to concentrate on the provision of clinical services, such as medication-use management, drug information services, medication-use evaluations, formulary management, and pharmacoeconomic analyses of anesthesia-related medications. These activities provide the best opportunity for the pharmacist to contribute to improving patient care and outcomes and containing costs. Finally, pharmaceutical services in surgery and anesthesiology should be periodically assessed for patient care and financial effectiveness.