This chapter focuses on the unique advantages of robotic bronchoscopy (RB), as well as the anesthetic requirements and challenges. The ability to locate and sample tissue from small nodules and from both central and peripheral lung fields is a great help in detecting early stages of lung cancer. To perform this task with minimal trauma is optimal for the patient’s experience. The role of the anesthesiologist is not only to keep the patient comfortable and safe, but also to optimize the anatomy and conditions for the pulmonologist to obtain adequate visualization and tissue sampling. Adequate sedation and analgesia are usually accomplished using total intravenous anesthesia (TIVA). Stable anatomic conditions can be achieved by utilizing neuromuscular blocking agents and atelectasis can be prevented by recruiting maneuvers, application of positive end expiratory pressure (PEEP), and the avoidance of 100% FiO2. These techniques can help avoid the influence of CT-to-body divergence—a major contributor to inaccurate navigation of the bronchial anatomy. A coordinated strategy between anesthesiologist and pulmonologist can help provide consistent, safe, and well-tolerated anesthetic management, while providing optimal conditions for the visualization of lung tumors and the retrieval of adequate tissue samples.