The surgical stress response encompasses both neurohormonal and immunological changes, which can lead to systemic inflammatory response syndrome (SIRS) characterized by hypermetabolism and hypercatabolism. Anesthetic drugs and techniques can modulate this response, influencing surgical outcomes. Preoperative measures such as premedication with beta-blockers, α2-adrenoceptor agonists, and immune-modulating nutrition can reduce the burden of surgical trauma. Intraoperatively, anesthetic techniques and drugs, including volatile and intravenous anesthetics, can influence the stress response. Volatile anesthetics are more effective in suppressing cortisol, ACTH, growth hormone, and catecholamines compared to intravenous anesthetics like propofol. Propofol, however, has anti-inflammatory properties and can modulate immune responses. Regional anesthesia techniques, such as epidural and spinal anesthesia, can also reduce the surgical stress response by inhibiting the HPA axis and sympathetic nervous system. Postoperatively, multimodal analgesia, early mobilization, and early enteral nutrition can further reduce the stress response and improve patient recovery. Despite mixed clinical evidence, the use of opioid-free anesthesia and the benefits of minimally invasive surgery are areas of ongoing research. The surgical stress response and its modulation are crucial for improving patient outcomes and reducing cancer recurrence.The surgical stress response encompasses both neurohormonal and immunological changes, which can lead to systemic inflammatory response syndrome (SIRS) characterized by hypermetabolism and hypercatabolism. Anesthetic drugs and techniques can modulate this response, influencing surgical outcomes. Preoperative measures such as premedication with beta-blockers, α2-adrenoceptor agonists, and immune-modulating nutrition can reduce the burden of surgical trauma. Intraoperatively, anesthetic techniques and drugs, including volatile and intravenous anesthetics, can influence the stress response. Volatile anesthetics are more effective in suppressing cortisol, ACTH, growth hormone, and catecholamines compared to intravenous anesthetics like propofol. Propofol, however, has anti-inflammatory properties and can modulate immune responses. Regional anesthesia techniques, such as epidural and spinal anesthesia, can also reduce the surgical stress response by inhibiting the HPA axis and sympathetic nervous system. Postoperatively, multimodal analgesia, early mobilization, and early enteral nutrition can further reduce the stress response and improve patient recovery. Despite mixed clinical evidence, the use of opioid-free anesthesia and the benefits of minimally invasive surgery are areas of ongoing research. The surgical stress response and its modulation are crucial for improving patient outcomes and reducing cancer recurrence.