The ambulatory division traces its inception to 1998. The field of ambulatory surgery was just beginning when a small group of Duke anesthesiologists, surgeons, nurses, and staff joined forces to form the first stand-alone Duke Ambulatory Surgery Center (ASC), separate from the main, inpatient hospital. The current chief of both ambulatory anesthesiology for the Duke University Health System and the Ambulatory Anesthesiology Division for Duke Anesthesiology, Dr. Stephen Klein, was a member of that small team who embarked on this ambitious mission. Motivated to provide high quality, patient centered, innovative care, Dr. Susan Steele, the first division chief, was recruited to lead the development of the new center. Capitalizing on her passion for patient care, team building and regional anesthesia, along with founding members, Drs. Roy Greengrass, Stephen Klein and Karen Nielsen, the center became known internationally for contributions to the field of regional anesthesiology, research, education, and equipment development. Today, this spirit of patient care and innovation continues. With newer members, Drs. Michael Kent, Alex Cravanas and Michael Doden, the division is using its knowledge and past experience to build the care pathways for the Duke University Health System’s future. The planned expansion of ambulatory surgery and the development of several free-standing centers will provide the division the opportunity to grow Duke’s ambulatory surgery footprint and continue leading the field.