An increasing proportion of surgeries are performed in freestanding ambulatory surgery centers (ASCs) rather than in hospitals. This study examined closed anesthesia-related malpractice claims of ASCs and hospital-based operating rooms (HORs) to examine any differences in severity of injury, major injuries, allegations, comorbidities, contributing factors, and financial value of the claim. The most common type of injury in both ASC and HOR was dental injury followed by nerve damage. Claims with higher severity of injury were less frequent in ASCs compared to HORs, but patient burns and poor communication between patients and providers were more frequent issues among ASC claims.