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An accurate and thorough preoperative history is a key component of any procedure. The preoperative history allows the interventionalist to appropriately plan the procedure. This includes devising the optimal approach, anticipating potential complications, providing safe and effective conscious sedation, ordering the appropriate supplies, and ultimately performing a successful intervention. It is very important that the history is taken personally by the physician who will perform the procedure. A pertinent history can be obtained relatively quickly, but the extra effort expended taking a thorough history is time well spent. The interaction with the patient while taking a history allows the physician the opportunity to develop an overall evaluation of the patient and establish a good rapport and often helps to decrease the patient’s anxiety before starting the procedure. Unlike most surgical procedures in which the clinician meets the patient in clinic to evaluate them prior to scheduling a procedure, the interventionalist is often meeting a patient for the first time immediately prior to the procedure. In that short period of time, the interventionalist must determine if the requested procedure is indicated and/or appropriate and whether it can be safely performed on each individual patient. Despite the fact that it is often colleagues and practice partners requesting a procedure, the well-being of the patient is ultimately the responsibility of the person performing the procedure. The history is a key factor in making these determinations and ensuring the patients safety.