The ongoing opioid crisis and opioid related fatalities have been exacerbated by the COVID-19 pandemic. Although opioids are sometimes necessary to manage pain, they carry substantial side-effects as well as serious risks including abuse, misuse, diversion, addiction, overdose and even death. Even short term post-operative prescriptions can lead to chronic opioid use or an opioid use disorder. As surgeons and otolaryngology providers we must contribute to safely reducing the use of opioids and their associated risks. There are evidence-based approaches to reduce postoperative opioid use, utilize multi-modal non-opioid pain management and safely administer opioids when they are necessary. The purpose of this session is to review the evidence around these peri-operative strategies in both children and adults. Specific and practical strategies to apply opioid-sparing techniques as well as how to safely provide opioids will be provided. Tips to incorporate these strategies into everyday otolaryngology practice will be discussed. Evidence based strategies utilized by anesthesiologists and pain medicine physicians will be shared along with recommendations for collaborating with these colleagues regarding your patients’ pain management. Time will be available for questions regarding safe and effective perioperative pain management.