Fast track surgery is a global healthcare package for the care of the patient in the peri-operative period. It consists of a multi-disciplinary team approach where several interventions of surgery, anaesthesia, nursing, nutrition and physical rehabilitation are simultaneously applied to expedite recovery. Other than surgical technique the cornerstone of a successful fast track program is anaesthesia delivery. By using the several interventions at the disposal of an anaesthesiologist there should be a reduction in the surgical stress induced on a patient. Each phase before, during and after surgery is targeted to employ techniques known to facilitate early recovery after surgery. The Anaesthesiologist-Surgeon partnership is crucial in effective peri-operative management of the patient. Understanding each one's role and places where their paths coincide is essential. The healthcare delivery system stands to gain a lot from the effective implementation of a fast track surgery program. Strict adherence to fast track principles has shown to be beneficial but there is scope of flexibility and individualisation. An appropriate fast track policy is one which is suited to meet local requirements and formulated with facilities that are locally available. Even though it has been demonstrated that fast track surgery is safe and effective there has not been across the board acceptance of all its aspects.