This learning activity explores pharmacogenomics in ambulatory surgery settings, examining how genetic variations affect medication responses during perioperative care. It details how cytochrome P450 enzymes and other genetic factors influence drug metabolism across key medication categories including anesthetics, analgesics, antiemetics, and cardiovascular drugs. The content outlines practical applications throughout the perioperative continuum, from preoperative screening to discharge planning, with emphasis on the nurse's role in monitoring for genetic-based medication responses. It addresses interdisciplinary collaboration, health disparities in pharmacogenomic testing access, and ethical considerations. Written for perioperative nurses, this educational material provides evidence-based guidance for implementing pharmacogenomic principles to improve patient outcomes within the time-constrained ambulatory surgery environment.