OBJECTIVES: In the last decade the population undergoing medical procedures is older and sicker. However, anesthetics (sedatives/hypnotics) administered during these procedures have not changed significantly during that time. This study sought to gain a better understanding of the sedative/hypnotic landscape in inpatient hospital procedures by examining populations receiving some of the more common drugs. METHODS: Adult inpatients with a procedure, discharged in 2014 who received etomidate or propofol, alone or in combination with other anesthetic agents were identified in the Premier hospital database. Data from 01/2013 to 09/2015 was used for trend analysis. Descriptive statistics were employed to understand patients’ demographics, therapeutic characteristics, resource utilizations and outcomes. Costs were adjusted to 2015 dollars. RESULTS: A total of 3,631,719 adult patients underwent a procedure in the hospital setting in 2014. Of which, 120,304 (3.3%) received etomidate and 1,246,093 (22.4%) received propofol. Compared to propofol patients etomidate patients were: older (64.7 vs. 60.2), sicker, with mean Charlson Comorbidity Index (CCI) 2.7 vs. 1.7, with higher percentage of patients in Mortality/Severity of Major or Extreme groups (73.0% vs.26.2% and 78.6% vs. 35.7%). The etomidate population had higher resource utilization ( LOS 10.9d vs. 6.0d; total cost $37,685 vs. $20,586); and higher death rate (15.8% vs 3.0%.) For the 3 year period, both populations demonstrated similar trends for mean age, CCI, LOS, Cost, and Mortality/Severity). CONCLUSIONS: In this assessment of propofol and etomidate, procedural administration of propofol is the dominant sedative/hypnotic of use but there are marked differences in patient characteristics between the two agents. Etomidate patients are older, sicker, have a longer LOS and use more health care resources. Further research is necessary to understand if these factors may be influenced by technique or concomitant medications.