More and more children undergoing both invasive and noninvasive procedures are receiving intravenous conscious sedation (IVCS). Medications including midazolam and fentanyl are used to provide both anxiety and pain relief, whereas barbiturates such as pentobarbital induce sleep for more sensitive studies including diagnostic imaging. An emphasis on proper staff education regarding airway management, medication delivery, patient assessment, and monitoring is essential for safe administration and care. In addition, planning should include preparation time for the patient and family. Adequate patient education as well as proficiency of the clinician enables IVCS to be delivered safely and effectively to achieve the desired outcome with limited risk to the patient.