A publicly available SPSS database was obtained at the National Practitioner Data Bank website (www.npdb-hipdb.com). After analysis, we found that between 1991 and 2004, there were 276,274 medical malpractice-related payments in the United States. During that period, 8297 anesthesia-related malpractice payments were made on behalf of practitioners in the United States. When adjusted for population growth, there was a 27.7% decrease in the annual number of anesthesia malpractice payments per 100,000 people during the period 2001-2004 as compared with the period a decade earlier 1991-1994 (0.26 versus 0.19). Also, the median anesthesia malpractice payments, adjusted to 2005 dollars, increased significantly from 1991 to 1994 and 2001 to 2004 (69,330 dollars versus 205,222 dollars). We conclude that over the past 14 yr, whereas the number of anesthesia malpractice payments has decreased, the median payment of cases has increased.