In this issue of Pediatric Clinics of North America , guest editors Drs. Moises Auron and Mirna Giordano bring their considerable expertise to the topic of Perioperative Management and Optimization of the Pediatric Patient with Complex Medical Needs . Top experts address common physiologic considerations in the perioperative period in most patients with complex medical issues, and discuss specific patient populations (e.g. patients with ventriculoperitoneal shunts), providing the information and tools needed by pediatric clinicians to update their assessments and mitigate risk factors. Contains 14 relevant, practice-oriented topics, including preoperative health assessments for children with medical complexity undergoing major surgeries; shared decision-making for children with medical complexity and their caregivers during perioperative time; perioperative pharmacological considerations; enhanced recovery after surgery (ERAS) for children with medical complexity; interdisciplinary perioperative care for children with medical complexity; and more Provides in-depth clinical reviews on perioperative management and optimization of the pediatric patient with complex medical needs , offering actionable insights for clinical practice Presents the latest information on this timely, focused topic under the leadership of experienced editors in the field. Authors synthesize and distill the latest research and practice guidelines to create clinically significant, topic-based reviews.