Fast track (FT) surgery is a multimodal concept aiming to reduce postoperative pain and stress-induced organ dysfunction. Key elements are perioperative fluid restriction, epidural analgesia, early oral nutrition and early mobilization. Therefore, multidisciplinary teamwork is required in order to obtain the optimal outcome of reduced postoperative complications and a hospital stay of only three or four days after open colectomy. Most of the patients undergoing colorectal surgery qualify for FT surgery. Meanwhile, FT principles are applied in a variety of open and laparoscopic procedures. The aim of this review is to highlight the principles of FT and to answer the question why FT surgery should nowadays be considered as standard care.