Myasthenia gravis is an autoimmune disease in which autoantibodies interact postsynaptic nicotinic acetylcholine at the neuromuscular junction which decreases the capacity of the terminal plate to transmit the nerve signal. For the anesthesiologist may be difficult extubation at the end of the procedure, especially if interference drugs are used at the neuromuscular junction. This review addresses the steps to be followed in perioperative management with flowcharts.