Due to medical advances in surgery and anesthesia and cost of hospital stays, more elective pediatric surgical procedures are being performed in outpatient settings. One proposed advantage of outpatient surgery is decreased anxiety or a shorter period of anxiety for pediatric patients and their families because they are able to go home shortly after the surgery. A literature review was conducted to describe anxiety experienced by pediatric patients and their families in the outpatient surgery setting and to explore ways to decrease that anxiety. Both children and parents reported not feeling emotionally and educationally prepared for outpatient surgery. Developmentally appropriate pre-surgical educational programs and parental involvement in the surgical experience can help alleviate the anxiety of both children and parents during the pediatric surgical experience. Nurse practitioners (NPs) are currently being used in pre-operative outpatient settings to conduct physical examinations and provide pre-op education. Pre-op education programs provided by NPs are beneficial in decreasing the anxiety state among children and parents prior to surgery.