Access to surgical care and essential anesthesia is an integral part of universal health coverage. Also, increasing access to surgical care depends on a parallel increase in access to safe anesthesia. Today, five billion people (more than two-thirds of the world’s population) still do not have adequate, quality surgery and anesthesia care at the right time. Therefore, the World Federation of Societies of Anesthesiologists and the World Health Organization developed the International Standards for Safe Practice of Anesthesia. The standards include the following components, which are essential for the safety of patients undergoing surgical procedures: professional expertise, facilities and equipment, medications and intravenous fluids, monitoring, and anesthesia. In this article, it is emphasized that wherever and whenever possible, anesthesia should be provided, led, or overseen by an anesthesiologist. It is also strongly recommended that essential equipment is in place and adequate training to handle it safely has been provided. Unfortunately, some operating rooms of small hospitals and clinics does not meet the above standards. It may be difficult for each hospital to manage autonomously due to the lack of a unified checklist for essential standardized requirements. By introducing appropriate anesthesia safety standards in the operating rooms of small hospitals and surgery clinics, it will be possible to increase patient safety during surgery performed under general anesthesia, deep sedation, moderate sedation, or regional anesthesia. Through this process, it is expected that the mortality and morbidity rate of unexpected surgery patients can be minimized.