Neuromuscular blocking agents (NMBAs) are used in many surgical procedures and have enabled new surgical advances. The expanded landscape of NMB reversal drugs allows for fast and complete neuromuscular blockade (NMB) reversal and the reduction of postoperative complications from residual block. In the United States, neostigmine/ glycopyrrolate and sugammadex are the primary agents for pharmacologic antagonism of NMBAs. While neostigmine and an anticholinergic have been available for decades, sugammadex has only recently become available. We present real-world cases in a variety of surgeries and clinical settings in which the use of NMB reversal agents played a significant role in the patients clinical outcome.