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Samuel Debas Bayable, Melaku Bantie Fetene, Molla Amsalu Tadesse College of Medicine and Health Science, Debre Berhan University, Debre Berhan, EthiopiaCorrespondence: Samuel Debas Bayable Tel +251 9-11-43-75-07Email samueldebas88@yahoo.comBackground: Assessing the quality assurance of providing work-ready anesthesia equipment in operating rooms is so vital. Most of the anesthesia-related adverse events are preventable by the identification and correction of anesthesia machine errors and equipment preparation in the pre-induction period. This paper aimed to keep a high-quality environment for workers and patients in the surgical operating theater.Materials and Methods: Data were collected after ethical clearance obtained from the institutional ethical review board, and daily observations of pre-induction anesthesia preparation were done in all surgical rooms at the start of each day and continuously before the next cases with a prepared anesthesia machine checklist. Descriptive statistical analysis and cross-tabulation of each checklist with the type of anesthesia and urgency of surgery were done to determine the degree of staff compliance with daily preparations using SPSS version 22, and finally, results were presented by texts and graphs.Results: In this study, a total of 61 checking events with 19 items were involved during the study period. There were 893 (77.1%) fully met checking events, 205 (17.7%) not-met checking events(sodalime) 61 (5.3%) not available in anesthesia machine check and equipment preparation before use. Among 19 checklists, only three (power source plugged in, power source switched on, and functionality of monitoring) were perfectly completed; however, the rest sixteen checklists are in bad practice among them seven checklists (presence of functional self-inflating bag, automatic machine check, power source backup battery, anti-hypoxic device, ventilator, difficult airway equipment and scavenging systems) were checked below 90%.Conclusions and Recommendations: This study concludes there is poor compliance among anesthetists in pre-induction preparation and underperformed since all anesthesia machine checklists have zero tolerance for errors. . This paper recommends that every responsible anesthetist perform anesthesia machine check and equipment preparation regardless of the type of anesthesia and type of surgery and avoid professional negligence.Keywords: anesthesia equipment preparedness, anesthesia machine, Audit; checklist