Sedation and pre-anaesthetic medication are part of the daily routine in small animal practice. It is important to understand the pharmacology of the different drugs used so that the most appropriate combination for each individual patient can be chosen. This chapter looks at aims of pre-anaesthetic medication and sedation, pharmacology, drugs used for pre-anaesthetic medication, drugs protocols, general recommendations to optimize pre-anaesthetic medication in cats and dogs, choosing the right drug combination, inadequate sedation and monitoring and support of the sedated patient.