Introduction: Nowadays, the role of the anesthesiologist during digestive endoscopic procedures has become indispensable for different reasons, among which stands out providing safety to the patient. There are different anesthetic techniques, intravenous sedation being the most common since it provides analgesia and decreases the state of consciousness, avoiding the somatic response of the patient during the procedure. Objectives: The purpose of this review is to explore the safety of deep sedation in the endoscopy room. Topics to be covered include sedation levels, the most commonly used drugs, and the determining factors of each patient, to optimize the safety of the procedure and improve results. Methodology: PubMed, Science Direct was searched using sedation, gastrointestinal endoscopy, anesthesiologist, as search terms. Results and Conclusions: Multiple drugs—with different levels of sedation—can be used, depending on the performed procedure and the individual characteristics of each patient.