For many surgery types, epidural analgesia, regardless of agent and catheter placement location, provides better postoperative analgesia compared with parenteral opioids. However, not all patients who can receive epidural analgesia do so. This study’s goal was to survey randomly selected USA anesthesiologists to learn of their perceptions when selecting analgesic techniques. 200 anesthesiologists contacted by telephone in May 2004 satisfied inclusion criteria: full-time-practice for >2 years, caring for >250 patients/year. A predetermined list of questions was asked. Pearson-chi-square and Kruskal-Wallis tests assessed association of categorical responses to unordered/ordered categorical descriptions. P-values were calculated using Monte-Carlo-simulation(StatXact-6). The respondents’ (82% male) average age=47 yrs, yrs in practice=17. 71% regularly used IV PCA, 45% regularly used epidural analgesia, while 38% regularly used nerve blocks. More than 75% of anesthesiologists reported “patient preference” and “evidence-based-practice-guidelines” were among the two most important factors in “selecting a treatment for postoperative pain,” excluding the anesthesiologist’s own expertise. 26% stated “hospital formulary” was important in analgesia choice, but less often among practitioners frequently using nerve blocks(P=0.0028). “Patient’s insurance coverage” and “family member preference” were listed in the top two by only 5%. 79% of anesthesiologists would use epidural analgesia more frequently if similar efficacy could be achieved without an indwelling catheter, perhaps because 96% agreed that bleeding risk with patients taking anticoagulants affects their decision-making. Very few (2%) anesthesiologists avoid epidural analgesia due to patient complaints about indwelling catheters. Few (13%) anesthesiologists avoid IV PCA or peripheral nerve blocks because of complications with tubing/pumps. For 59% of anesthesiologists, “the amount of monitoring required post-surgery” impacted “selection of postoperative pain treatment,” less so among anesthesiologists often using epidural analgesia(P=0.0027). Excluding the anesthesiologist’s own expertise, patient preference and practice guidelines are two important factors affecting analgesic choice for the three surgery types studied.