Preoperative evaluation is an essential step in all surgeries, and vitreoretinal surgery is no exception. Accurate and objective preoperative evaluation helps the surgeon better understand the patient’s needs, develop an individualized treatment plan, and set realistic expectations for surgical outcomes, thereby laying a solid foundation for a long-term, positive physician-patient relationship. Anesthesia for vitreoretinal surgery also has certain unique aspects, particularly local anesthesia, which is typically administered by the surgeon. Knowing how to avoid related complications while ensuring effective anesthesia is also a key area that beginners in vitreoretinal surgery need to master. This chapter briefly describes the preoperative evaluation and anesthesia precautions.