AbstractIt is known that patients with pulmonary hypertension are at high risk for anaesthesia and surgery. Primary pulmonary hypertension (PPH) has now been replaced byidiopathic pulmonary hypertension or pulmonary artery hypertension (PAH). PAH is arareform of progressive fatal disease. Occasionally these patients may be posted for non cardiac surgeries.Ideal anaesthetic technique involves maintaining of stable pulmonary and hemodynamicparameters for a possible good outcome. Here we present a 31 year old female with severe pulmonary artery hypertension who underwent successful excision of a hugevulvalmass.