Donor shortage remains a critical problem in transplantation. Good management of available donors is a high priority. The majority of donors are heart beating, brain dead cadaveric donors from whom multiple organs are procured for transplantation. Most of these cadaveric donors have significant physiologic defects, which are magnified after brain death. Expeditious correction of these defects is vital to good function of the organs after transplantation. Optimal donor management can also impact long term graft function. The other critical factor in organ procurement is a technically sound retrieval of donor organs. Anatomical variations and abnormalities must be diligently identified while performing an expeditious retrieval of the organs. Most retrieval procedures are performed on an emergency basis with teams from different transplant centers working together in unfamiliar operating conditions. Anesthetic management of the cadaveric donor is important since the brain dead donors are frequently unstable from a cardiovascular standpoint. Donor procurement is a highly complex procedure that is coordinated exquisitely by organ procurement agencies. Donor procurement is a cooperative endeavor, which contributes to the health of the recipients. The donor families view organ donation as the only good thing that comes out of an otherwise tragic incidence.