This is a comprehensive article, which provides a good summary of the common co-morbidities affecting patients presenting for oral surgery. It focuses on their management issues as well as precautions required when administering anaesthesia. For each illness listed the authors give a brief relevant background and summary of how to appropriately assess the condition preoperatively as well as manage it perioperatively regarding the use of anaesthesia. Clearly the American experience contrasts significantly to the UK. In America the operative / anaesthetist model in an office based setting is the norm and the perioperative summary may not be as relevant to UK surgeons, however, the other sections are certainly useful and well presented and should be required reading for the junior members of the team. If you want an up-to-date concise discussion on complicating medical illnesses and their anaesthetic considerations then look no further.