Abstract : One of the proper clinical practices applied in emergency medicine departments is the medical technique of procedural sedation and analgesia (PSA). The sedation level should be modified somehow that patients be able to undergo undesirable medical conditions and also preserve normal consciousness and physiological reflexes while being able for considering and responding to tactile or/and verbal stimulations. In spite the fact that the most frequently applied drugs for procedural sedation are broadly safe, but improper dosing or monitoring would increase adverse side effects. It should be noted that applying the technique of procedural sedation in emergency medicine departments may bring risks along. Appropriate medical monitoring from one side, and providing proper accessibility to resuscitation possibilities with the presence of properly educated staffs of emergency units for immediate management of airway and supporting the life of patients in an advanced way from the other side, could decrease the harmful consequences of treatment. For proper screening of compatibility of procedural sedation and evaluation the main risk factors, preprocedural assessment should be done. Patients who have improper airway, are in full stomach condition or have considerable medical diseases should take higher levels of conscious sedation and also should consider alternatives to procedural sedation. The medical professional doctor which is responsible for carrying out procedural sedation must be educated properly from the point view of operation, dose, consequences, side effects and antitoxin of frequently applied sedative analgesics. The recent developed novel and advanced techniques are such as the chemical compound of Inhalational anesthetic, drug delivery system of transmucosal, target controlled sedation (TCS), patient-controlled sedation (PCS) and transnasal esophagoscopy. After procedural sedation process, all patients must be undergoing medical monitoring and also must be kept at the recovery room until they present all required criteria’s for being discharged