Hand hygiene (HH) compliance continues to remain poor amongst anesthetists mainly because of multi-tasking and the need for repeated HH. We aimed to quantify HH compliance amongst anesthesia providers while performing anesthesia-related procedures inside operating rooms. The observations for HH before and after procedures, including placement of intravenous cannula, intubation, central line placement, arterial line placement, and neuraxial and peripheral nerve block, were made by a single observer in operating rooms where elective surgeries are carried out. The overall compliance of all health care workers was 39.6%. Resident physicians were less likely to be compliant than consultant physicians and there was significant variation in procedure-related HH with maximum compliance before neuraxial block (100%) followed by arterial line placement (93.7%), central line insertion (86.7%), and peripheral nerve block (80%) (P <.001). The compliance after performing the above procedures was < 50% for all procedures. Copyright (C) 2015 by the Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.