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Carcinoid tumors are neuroendocrine tumors (NET) that secrete hormones and other substances into the circulation, causing shifts in hemodynamics and other unpleasant symptoms. This case report describes a case in which the patient had a midgut NET that metastasized to the liver, causing carcinoid syndrome. The patient underwent general anesthesia for an exploratory laparotomy, small bowel resection with anastomosis, mesenteric mass resection, and a right liver lobectomy. The patient had carcinoid syndrome and developed carcinoid crisis during the surgery. Octreotide and phenylephrine infusions and phenylephrine boluses were used during the procedure to stabilize hemodynamics. The pathophysiology of carcinoid tumors, carcinoid syndrome, carcinoid crisis, and carcinoid heart disease are reviewed and octreotide application in the setting of carcinoid syndrome and carcinoid crisis is also reviewed. Octreotide is a first-generation somatostatin analog that binds to somatostatin receptor 2 with high affinity, somatostatin receptor 3 and somatostatin receptor 5 with lower affinity, and suppresses the secretion of serotonin. Anesthesia recommendations are given for patients undergoing surgery with carcinoid syndrome., Competing Interests: Name: Bryan Wiederholt, DNAP, CRNA Contribution: This author made significant contributions to the conception, synthesis, writing, and final editing and approval of the manuscript to justify inclusion as an author; this author is the corresponding author. Disclosures: None. Name: Timothy Gengler, DNAP, CRNA Contribution: This author made significant contributions to the conception, synthesis, writing, and final editing and approval of the manuscript to justify inclusion as an author. Disclosures: None. Name: Jen Bendure, DNP, CRNA Contribution: This author made significant contributions to the conception, synthesis, writing, and final editing and approval of the manuscript to justify inclusion as an author. Disclosures: None., (Copyright © by the American Association of Nurse Anesthetists.)