BACKGROUND Little is known regarding the factors that influence post-residency career decisions following anesthesiology residency training. The objective of this study was to assess the relationship between demographic and academic variables and immediate post-residency positions. METHODS The authors conducted a retrospective review of anesthesiology resident files from 2000 to 2014 at Mayo Clinic (Rochester, MN). Univariate and multivariable analyses were used to assess relationships between demographic and academic factors and post-residency positions. RESULTS Of the 263 anesthesiologists included, 120 (45.6%) pursued fellowship training, 110 (41.8%) entered private practice, and 33 (12.5%) entered directly into academic positions. Factors associated with career choice in univariate analyses included age, gender, country of citizenship, country of medical school, type of medical degree, and the number of peer-reviewed publications. In multivariable analyses, age, gender, and number of publications were significant predictors of post-residency career choice. Specifically, older residents were less likely to pursue fellowship training and more likely to directly enter academic positions. Males were more likely to obtain private practice positions compared to females, who were more likely to pursue advanced fellowship training. Nearly all residents entering into academic positions had at least one peer-reviewed publication. CONCLUSIONS In this 15-year analysis of anesthesiology resident career decisions, age, gender, and number of publications were the primary predictors of career decisions. Future studies are needed to determine generalizability and to evaluate additional socioeconomic factors with the ultimate goal of optimizing residency recruitment and training initiatives in congruence with resident career interests and departmental goals.