Worldwide, 1.8 billion people live in conflict-affected areas. Providing safe anaesthesia and surgery to victims of war and natural disasters in resource-limited settings remains a significant global problem. Ketamine has the advantage of providing analgesia and anesthesia while maintaining upper airway reflexes and spontaneous breathing. With skilled use, this allows some surgical procedures to be performed without advanced airway management. Ketamine is the drug of choice when access to anesthesia machines is not available. It does not affect hemodynamic stability which is important in severe bleeding situations. Because ketamine is sometimes abused as recreational drug, some countries have requested that ketamine be scheduled under international drug control conventions. However, the World Health Organization’s Expert Committee on Drug Dependence has repeatedly not recommended such restrictions, and in 2016, the country requesting scheduling withdrew the proposal before it came to a vote at the United Nations Commission on Narcotic Drugs. If such scheduling were to occur, the availability of ketamine would decrease dramatically, with the greatest impact on the health of people living in low- and middle-income countries.