Effective postoperative pain control is a critical component of high-quality perioperative care, influencing patient satisfaction, postoperative recovery, and key clinical outcomes such as mobility, pulmonary function, and opioid-related complications. Acute Pain Services, when led by anesthesiologists, provide a structured, evidence-based framework to optimize analgesia while advancing the broader goals of safety, efficiency, and value. This chapter explores the core functions of a modern pain service, including multimodal analgesia, regional anesthesia techniques, patient and staff education, protocol development, and real-time clinical oversight. It examines how anesthesiologists integrate physiology expertise, risk assessment, and interdisciplinary collaboration to tailor pain strategies to diverse surgical populations, including high-risk and opioid-tolerant patients. Beyond direct clinical impact, the chapter highlights the measurable institutional benefits of such programs, such as reduced length of stay, improved throughput, and lower rates of complications and readmissions. Through ongoing performance evaluation and system-wide leadership, physician anesthesiologists ensure the long-term success and sustainability of acute pain services as an essential pillar of perioperative medicine.