Obstructive sleep apnoea (OSA) is the most prevalent sleep disorder, affecting up to 5% of the population. It can have a considerable impact upon perioperative morbidity and mortality. Patients require thorough preoperative assessment including a detailed history, the use of scoring systems to assess severity (such as the STOP-Bang questionnaire and the B-APNEIC score) and physical examination, with particular attention to airway assessment. Elective surgical patients who are deemed to be of high risk for OSA should be referred for polysomnography and implementation of continuous positive airway pressure therapy prior to surgery if indicated. Those patients deemed to be of low risk may be suitable for day surgery. Intraoperative anaesthesia management may include regional anaesthesia, local anaesthetic infiltration, or general anaesthesia depending on both patient and surgical factors. Particular attention should be paid to the potential for difficult airway management and avoidance of sedative agents and opioids where possible. Patients with OSA have an increased risk of cardiovascular and respiratory postoperative complications. Postoperative management should be guided by the severity of OSA, the occurrence of adverse respiratory events in the post anaesthesia care unit and the requirement for opioid analgesia.