Abnormal cardiac repolarization, as indicated by prolongation of the QT interval on the standard electrocardiogram, is a risk factor for malignant dysrhythmias such as torsades de pointes. Qt prolongation in the perioperative setting is both common and likely underreported, as a minority of patients are monitored on telemetry in the perioperative period. Though QT prolongation may be congenital, the majority of cases seen in the perioperative setting are drug induced. Many different classes of drugs have been shown to prolong the QT interval, and the administration of multiple QT-prolonging medications may have an additive effect. It is imperative that the clinician be aware of which drugs commonly used in the perioperative setting may cause QT prolongation as well as the unique treatments for management of torsades de pointes beyond standard resuscitative measures.