The effective management of pain is a crucial component of good perioperative care and recovery from surgery. Unrelieved pain and inadequate pain relief have detrimental physiologic and psychological effects on patients by slowing their recovery. The key components to establishing a successful perioperative pain management service begins with an institutional commitment to support the service. The team must be built around a physician leader with training and experience in pain medicine, and other anesthesiologists must be available to support the service.