Rigid bronchoscopy is the cornerstone for managing complex airway diseases and is a defining skill for interventional pulmonologists. Rigid bronchoscopy is unique in that it provides the pulmonologist with the ability to conduct advanced endobronchial interventions while providing ventilation and oxygenation through the same airway access. The evolution of rigid bronchoscopy has enabled interventional pulmonologists to perform complex endobronchial interventions such as airway recanalization, thermal ablation, and bleeding control. This chapter provides insight into the anesthesia considerations for rigid bronchoscopy, focusing on preprocedural evaluation, scope of use, and special anesthetic considerations in particular situations. Anesthesia for rigid bronchoscopy has evolved alongside interventional pulmonology, moving from local anesthetics to general anesthesia due to the need for patient immobility and comfort during highly stimulating procedures. Preoperative planning is crucial, involving thorough patient evaluation, airway assessment, and preoperative optimization. While certain contraindications exist, most are relative as rigid bronchoscopy is often a life-saving intervention. The operating room setup demands specialized equipment and close coordination between the interventional pulmonology team and anesthesiologists, emphasizing the importance of shared access to airway and clinical monitoring. Additionally, anesthesiologists must become experts in both conventional mechanical ventilation and jet ventilation techniques. In most circumstances, the intraoperative anesthetic management involves total intravenous anesthesia with agents like propofol and remifentanil to achieve optimal anesthetic depth and rapid recovery. Muscle relaxants are frequently employed to facilitate scope insertion and prevent adverse airway reflexes. Postoperative care focuses on monitoring for respiratory distress and managing potential complications, with patient destination determined by the procedure’s nature and intraoperative course. Special considerations, particularly for patients with central airway obstruction, highlight the critical need for careful anesthetic induction, at times involving the maintenance of spontaneous ventilation, and tailored approaches for procedures like tumor debulking, bronchoplasty, and airway stenting.