There are many expert-identified recommended interventions to improve medication safety: few have been rigorously tested and proven. Adoption of electronic medication processes can and has reduced medication error on the wards and in the OR. More recently, comprehensive patient safety programs have been shown to reduce medication errorsaw well as mortality. Reduction of human error in medicine will require a comprehensive bundle of interventions rather than any single silver bullet.There are many things that most institutions and practitioners could do today: each of these may make only a small difference but the key to substantially improving safety lies in the aggregation of minimal gains. Our patients have a right to expect greater investment into medication safety by health care institutions, and greater engagement with medication safety by the clinicians who care for them. Although their time in the OR is only part of the surgical patient's perioperative journey, it is an important part. Implementation of these recommendations should be a minimum expectation for institutions and anesthesia departments today, and is an excellent foundation from which initiatives to improve medication safety can be extended to the rest of the surgical pathway.