AbstractOsteogenesis imperfecta (OI) is a rare, genetically inherited syndrome involving connective tissues which leads to fragile bones, short stature, disorders of other organs and body systems. Children with OI are more susceptible for bone fractures. OI poses various anaesthetic challenges like difficult intubation, problems with positioning, tendency to develop malignant hyperthermia, coagulopathy, cardiovascular and pulmonary abnormalities and spinal abnormalities. We report a case of 9 year old male boy with OI type IV, presented with fracture shaft of femur, posted for intra medullary nailing. It was successfully managed under spinal anaesthesia.