Introduction Anesthesia is an important specialty in the medical field responsible for caring for patients before, during, and after operations. It involves monitoring vital signs, managing pain levels, and regulating consciousness. There are various subspecialties of anesthesia, including general anesthesia, intensive care medicine, cardiac anesthesia, and pain medicine, among others. This study aims to assess and evaluate the knowledge and perceptions of medical students regarding the role of anesthesiologists and the factors influencing their career choices. Methods A descriptive cross-sectional study was conducted with 379 clinical-year medical students from colleges of medicine across Saudi Arabia. An online questionnaire consisting of 26 items was distributed among the medical students. The questionnaire included sociodemographic characteristics, factors influencing the choice of a career in anesthesiology, and perceptions related to the role of anesthesia. Statistical analysis was performed using RStudio [R Core Team (2021), R version 4.3.1, R Foundation for Statistical Computing, Vienna, Austria]. Categorical variables were presented using frequencies and percentages, while numerical variables were expressed using the median and interquartile ranges (IQRs). Results Among the 379 clinical-year medical students surveyed, a majority of participants (59.6%) reported undergoing a mandatory rotation in anesthesia during their fifth or sixth (final) year of medical school. It is noteworthy that good knowledge was significantly associated with having a mandatory rotation in anesthesia during the fifth or sixth year, with 96.0% of students who had a mandatory rotation demonstrating good knowledge, compared to 88.2%of those who did not. A smaller proportion (1.3%) opted for an elective anesthesia rotation during this period. Among those who undertook an elective clinical rotation in anesthesia, all respondents (100.0%) reported undertaking the elective rotation for three weeks or more and stated that this rotation inspired them to pursue a career in anesthesia. Regarding the factors influencing the choice of residency programs, a controllable lifestyle, particularly the ability to control work hours, emerged as the most influential factor, with 96.8%of participants considering it as such. This was followed by income (91.6%), the presence of a doctor-patient relationship (72.6%), and the prestige of the specialty (69.7%). Conclusion The medical students demonstrated reasonably good knowledge of the anesthesiologist's role, which can be attributed, in part, to the mandatory rotation in anesthesia. In terms of factors influencing career choice, a good lifestyle was found to be the most influential, followed by income, the doctor-patient relationship, and the prestige of the specialty.