The potential for a fire during surgical, perioperative, and interventional procedures should always be recognized. Free-standing ambulatory surgery centers, endoscopy centers, imaging centers, and physician's offices have gaps in emergency services and response teams. These areas need well-understood plans, intense orientation, and ongoing education because there is no one else to rely on until the fire department arrives. This article discusses fire safety issues, including prevention, suppression, evacuation, and communication, and highlights current regulations for patient safety issues.