The international project OrphanAnesthesia of the German Society of Anaesthesiology and Intensive Care Medicine (DGAI) and the Professional Association of German Anaesthesiologists (BDA) publishes recommendations for the anaesthesiological management of patients with rare diseases, to improve patient safety. The rare, wide-scattered knowledge and experience is gathered into a concise, practicable recommendation, published with free access on www.orphananesthesia.eu, and following in the online supplement of the Journal A&I: https://www.ai-online.info/supplements-orphananesthesia.html