Anaesthesia is evolving, so predictions about the future are hard to make. Three trends seem highly likely to result in changes in practice: understanding brain function, more intensive work at the molecular level, and advances in information technology. How likely are we to have an anaesthetic ‘autopilot’ in the future? ‘Anaesthesia tomorrow’ states that this outcome is unlikely. Anaesthetic care will always require human compassion and reassurance. However, advances will come from a desire to improve safety, to refine technique, to achieve and nurture expertise, and to alleviate human suffering.