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Remimazolam is a recently approved benzodiazepine sedative. We report a case of a 72-year-old man who experienced a cardiac arrest due to severe anaphylaxis immediately after general anesthesia induction. Based on the results of skin tests, including those for dextran 40, an excipient in the remimazolam solution, and a review of drugs given during 3 anesthetics, remimazolam was identified as the probable causative agent. Although remimazolam is structurally similar to midazolam, the patient was not allergic to midazolam as demonstrated