Reflex anoxic seizures (RAS) are a unique type of seizure that can present as life-threatening events, primarily affecting preschool children but also occurring in older individuals. Characterized by a vagally mediated response to noxious stimuli, RAS leads to bradycardia and potential asystole, resulting in cerebral hypoperfusion and hypoxia. This case report details a 20-year-old female patient with a history of RAS presenting for a routine molar tooth extraction under anesthesia. After years of misdiagnosis as epilepsy, her seizures were attributed to RAS, leading to the cessation of antiepileptic medication without increased seizure frequency. During her dental procedure, a series of preventative measures were implemented to ensure a safe anesthetic experience, including patient education, careful monitoring, and the availability of atropine and other interventions. The procedure was uneventful, and the patient was discharged as planned. This case highlights the importance of recognizing RAS in the perioperative setting and the steps that can be taken to mitigate risks during anesthesia.