Background The incidence of perioperative anaphylaxis increases with the extensive use of various medications especially synthetic ones in perioperative period. Objective To review the etiology, diagnosis, prevention and treatment of perioperative anaphylaxis, in order to promote the awareness of this life-threatening event for clinicians to reduce its mortality rate. Content Perioperative anaphylaxis is caused by a series of allergens the patients are exposed to during operation, including intravenous anesthetics (i.e. propofol), NMBA, opioid analgesics (morphine, fentanyl, sufentanyl, remifentanyl, etc), local anesthetics, α-galactosidase, and inhaled anesthetics. To prevent the allergic reaction, identification of allergy propensity should be screened with skin prick test or intradermal test before the administration of above-mentioned drugs, and early diagnosis of allergic reaction after drug administration should be carried out by examining plasma levels of histamine, Tryptase and IgE, and counting the number of activated basophil cells in the blood. The treatment of perioperative anaphylaxis includes anti-shock with adrenalin, bronchodilation with β2 adrenoceptor agonists, glucocorticoid, and anti-histamine drugs. Trend The primary intervention for perioperative anaphylaxis is to avoid exposure to the most common allergens, if allergy appeared, early diagnosis and treatment should be carried out. Moreover, the allergens should be identified to prevent the reoccurrence. Key words: Perioperative period; Anaphylaxis