This chapter examines the intersection of risk management and medicolegal considerations in anesthesiology, emphasizing the anesthesiologist’s central role in maintaining patient safety, quality improvement, and legal defensibility in perioperative practice. It explores how adverse events are identified, reviewed, and mitigated through structured quality review processes, accurate documentation, and understanding of human factors engineering. This chapter highlights how near misses, reporting barriers, and system design flaws influence safety outcomes and how anesthesiologists’ expertise positions them to lead institutional efforts in risk reduction. Medicolegal topics include malpractice principles, informed consent, and the critical role of professional society guidelines in defining standards of care. This chapter further discusses the implications of evolving care models such as the Perioperative Surgical Home (PSH) and Enhanced Recovery After Surgery (ERAS), which emphasize team-based accountability and value-based care. Finally, it addresses emerging legal questions posed by artificial intelligence (AI) in perioperative decision-making and liability. Through these lenses, this chapter defines how anesthesiologists can proactively integrate legal awareness, data-driven safety practices, and ethical decision-making to protect patients and institutions while enhancing perioperative quality.