This session was presented at the November 2012 Managing the Spectrum of Infection Prevention in Acute and Ambulatory Settings symposium held in Atlanta. The focus was on the evolution of ambulatory surgery and the issues and challenges being faced today. Since the opening of the first ambulatory surgery center there has been tremendous growth and the benefits associated with reducing cost to patients and the healthcare system has been great.With cost cutting efforts on the part of the government came issues such as reimbursement and infections resulted in the establishment of National Guidelines. The CMS developed the guidelines and conditions for coverage which are now being implemented. Standards for infection control practices and training of all staff are essential in order to receive reimbursement.