Smart Hospital development is one of the strategic development directions in Hospital Authority. Kowloon East Cluster(KEC) starts smart hospital development since the year of 2017. Smart Operation Theater (Smart OT) is one of the smart core team in KEC smart hospital development. Patient safety and operation efficiency is the focus of smart application development in Operation Theater. Smart OT in KEC is the first operation theater in Hong Kong to achieve complete electronic documentation and paperless workflow. Different self-initiate IT systems including Anesthetic Care Information System (ACIS), Peri-operative Nursing Information System (PNIS), Pre-anesthetic Assessment System (PAAS), Auto-charting of Vital sign (E-vital), Electronic Surgical Safety Checking with Patient Verification System, Smart Dashboard and Smart Dangerous Drug Cupboard etc. Apart from IT systems for operation workflow, smart initiatives like 手術之phone, VR for patient pain control, and tele-nurse-consultation for pre-anesthetic assessment are developed to improve patient satisfaction. KEC Smart OT team is a reliable partner with HAIT. Smart project like mobile surgical instrument tracking system (M-SITS), Geek project like Hololens and non-tactile control of patient film are under co-development.