The use of any anesthetic agent must be based on specific knowledge of its benefits and risks, how it may produce toxicity and in which patients it may be most safely administered. Clearly, the perfect anesthetic agent does not yet exist and individual patient circumstances will continue to dictate the choice and use of inhaled anesthetics in clinical practice. Reports such as that by Tungea et al. remind us of the need for continued vigilance. As ongoing research attempts to uncover emerging toxicities, the clinician is challenged to balance new information with current clinical practices and choose the safest, most effective agents for each patient.