While clinical practice over the past few decades has ushered in a great deal of progress in efficacy and safety for skeletal dysplasia patients undergoing complex orthopedic procedures, caring for these patients remains a challenging process requiring dedicated and specific resources, personnel, and care teams. These systems must function seamlessly and cohesively for patients with increasingly complicated medical comorbidities to prevent unforeseen consequences or potential delays. Smooth transitions in care planning and communication are critical to safety and patient experience. This can be further complicated by the distance that many patients will travel to receive care at tertiary or quaternary institutions. This chapter highlights the coordination and depth of care required to usher these patients from preoperative evaluation through their operative and recovery course to discharge and follow-up. The Department of Anesthesiology is responsible for coordinating past and current medical histories, guidance from many specialty services, and collaboration with our surgeon colleagues to create and implement a thoughtful and detailed perioperative care plan.