Deep Brain Stimulation (DBS) can be an effective treatment option for patients with essential tremors, Parkinson’s disease, dystonia, epilepsy, chronic pain, major depression, and its role is being evaluated in a variety of other neurological diseases. Anesthesia concerns take into account the primary pathology for which the device was inserted, assessment of device functioning and its interference with diathermy, electrical electromagnetic, ultrasound, and laser devices used perioperatively for different purposes. We discuss anesthetic management with a brief review of two cases with DBS device In Situ.