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Achieving adequate depth of anaesthesia during surgical procedures is desirable. Therefore, assessment and monitoring/ measurement of the depth of anaesthesia are fundamental to anaesthetic practice. The purpose of this review is to identify the risk factors that may be associated with intraoperative awareness, provide decision tools that may enable the clinician to reduce the frequency of unintended intraoperative awareness, stimulate the pursuit and evaluation of strategies that may prevent or reduce the frequency of intraoperative awareness, different types of tools developed to date to monitor the depth of anaesthesia, provide guidance for the intraoperative use of different monitoring tools as they relate to intraoperative awareness and how to approach a patient when awareness is reported by the patient along with current guidelines in the use of current available monitors.