‘Tropical Medicine and Anaesthesia 1’ (BJA Education 2018; 18,2: 35e40) focused on those common tropical diseases that can affect anaesthetic practice in any setting. This second article is concerned with the practice of anaesthesia in trop- ical locations, and explores further those tropical diseases that may require surgical intervention, and the medications that may interact with anaesthetic agents. Some of the issues around blood product administration in the tropics are also discussed.