Anesthetic plans for oculofacial surgery usually include topical local anesthetics and/or nerve blocks, or regional anesthesia (RA). They may also involve monitored anesthetic care (MAC) or full general anesthesia (GA). RA uses local anesthesia (LA) within peribulbar, retrobulbar, and sub-Tenon's nerve blocks to achieve pain control and akinesia of specific orbital structures. Retrobulbar, peribulbar, and sub-Tenon's nerve blocks allow for anesthesia of the cornea, uvea, and conjunctiva alongside providing akinesia of extraocular muscles. MAC involves sedative, anxiolytic, and analgesic medication alongside continual monitoring to maintain moderate to deep sedation. GA, in which a patient is maintained within an unarousable state, may be necessary in the context of more invasive procedures or with certain patient conditions. This chapter details safe and effective anesthesia protocols for oculofacial surgery.