Safe anaesthesia for neonates is based on understanding their unique physiology and response to medications so as best to provide analgesia and amnesia, depress stress responses, maintain cardiovascular stability, and return them to baseline status. Medications administered by any route have a similarly rapid uptake followed by the slower elimination phase as adults. However, the duration of these phases is altered by changes in body composition, protein binding, and maturation of organ function. To review all the recent guide lines in the anaesthetic management of neonates to provide the anesthesiologist with an understanding of the basics, clinical aspects and recent advances in the anaesthetic management of neonates. Surgical procedures in the first month also are considered emergent, or at least urgent, surgery. The most frequent surgical procedures in the first month are exploratory laparotomy for NEC, inguinal hernia repair, correction of pyloric stenosis, patent ductus arteriosus [PDA] ligation, a shunt procedure for hydrocephalus, and placement of a central venous catheter.