<p>Anesthesia in interventional radiology (IR) is a dynamic and constantly evolving medical field, shaped by technological advances and clinical challenges specific to this discipline. IR has experienced significant expansion, becoming an essential modality for the treatment of various pathologies, ranging from vascular diseases to oncological interventions. This development has paved the way for an expanded range of procedures, sometimes involving fragile patients or those with comorbidities, presenting anesthesiologists with new patient management strategies. Technological advancements in interventional imaging demand increased precision in the planning and administration of anesthesia. Optimization of intubation techniques, airway management, and adjustment of pharmacological protocols become imperative to ensure patient safety and comfort. Individualization of anesthesia protocols becomes a necessity, requiring close collaboration between interventional radiologists and anesthesiologists to define optimal, case-specific strategies. These protocols must consider the duration of procedures, patient positioning, the potentially painful nature of the intervention, as well as the patient's physiological status and ability to tolerate general anesthesia. Anesthesia conditions should be discussed between interventional radiologists and anesthesiologist-intensivists, addressing the need for muscle relaxation, the possibility of performing the procedure under sedation/hypnosis, and the prediction of postoperative pain, aiming to provide the patient with the best possible care. This article aims to contribute to the enhancement of knowledge in IR anesthesia by providing a solid foundation for innovative and secure anesthetic practices in the specific context of interventional radiology.</p>