Veterinarians often need to sedate or anesthetize fish to perform physical examinations or other diagnostic procedures. Sedation may also be required to transport fish. Painful procedures require complete anesthesia with appropriate antinociceptive agents. Regulations and withdrawal times apply to food animal species in many countries. Specific protocols are therefore warranted in commercial fish versus ornamentals. Tonic immobility of elasmobranchs and electric anesthesia should never be used to perform painful procedures. Anesthetic monitoring in fish remains challenging. This review summarizes ornamental fish anesthesia and discusses techniques used in the commercial fish industry and in field conditions.