Herbal medicines are biochemically active compounds that have the potential to interact with drugs used in anesthesia. Lack of herbal standardization makes definitive diagnosis of herb-anesthesia interaction difficult. However, identified herbal use and an understanding of possible interactions can alert the anesthesia provider and raise suspicion of possible herb-related complications. In a recent survey, 22% of patients undergoing surgery reported herbal medicine use. Most patients using herbal remedies fail to report this use to their healthcare providers. Herbal medicine use is not routinely addressed during the preoperative interview. The interviewer should include open-ended questions such as: "What herbal or vitamin supplements do you currently take?" The purpose of this review is to give an industry overview and look at commonly used herbal medicines, focusing on those with the greatest potential for anesthetic and operative complications.