Children have the right to enjoy the highest attainable standard of health.This basic human right is anchored in the "United Nations Convention on the Rights of the Child (UNCRC)" and was adopted in 1989.Pediatric anesthesia is a high-risk specialty with anesthesia-related complications approximately 10 times more frequent when compared with adults resulting higher morbidity and mortality.Children are different from adults from an anatomical, physiological, pharmacological, psychological point and safe conduct of pediatric anesthesia requires profound knowledge, experience, manual skills and professional attitude of the practitioner.This also necessitates institutional support in a child appropriate clinical environment.Unfortunately, we are still far away from fulfilling this commitment in anaesthesia and continue to be hampered by the lack of human and physical resources, organization, and training.Safe Anesthesia for Every Tot (safetots.org) is an initiative of leading international pediatric anesthetists that advocates safe and quality anesthesia for all children.It is based on the rights of the children ('10R'), the provision of perioperative physiological homeostasis ('10N'), defines the '5W' (Who, Where, What, When and HoW), critical events '10C', provides a roadmap for education, teaching and training and identifies specific areas of critical importance for safe perioperative care.This review provides an overview of the perioperative safety in pediatric anesthesia and explores strategies to minimize risks.