ASA is governed by its House of Delegates. The House of Delegates is comprised of ASA Delegates and Directors (designated by geographic distribution), ASA Officers, Past Presidents, the Editor-in-Chief of the journal, Anesthesiology, Chairs of the Sections on Administration, Representation, Professional Standards, Professional Practice, Society Subspecialties, Education and Research, Annual Meeting and Clinical Care, and the ASA Delegate to the AMA House of Delegates. The House of Delegates meets each year during the Society's Annual Meeting.

During the interim between the meetings of the House of Delegates, the ASA Board of Directors exercises authority to manage the business and financial affairs of the Society, and superintends and directs the publication and distribution of all official documents, journals and reports consistent with policies of the House of Delegates. The Board of Directors meets three times each year.

The Society also has many special committees comprised of the nation's outstanding anesthesiologists. In addition, 55 Component Societies work to implement and complement the Society's goals at the community level.

There are approximately 55 persons on the ASA staff in Park Ridge, Illinois and 9 in Washington, D.C. who implement the programs and policies developed by ASA.