Introduction: The varicella zoster virus (VZV), a DNA virus in the herpes family, causes chickenpox, a generally mild but contagious illness. About 5–10% of pregnant women lack VZV antibodies and can contract varicella during pregnancy. The impact of primary VZV infection varies with the gestational period: maternal complications are highest in the third trimester, while fetal risks are greatest in the first and second trimesters. Mitral stenosis from rheumatic fever is the most common valvular heart disease in pregnancy, usually emerging due to cardiovascular changes. Improved care has reduced related mortality and morbidity. Case Report: A 25-year-old female diagnosed with G2P1L1 with 36 weeks 4 days gestation with active varicella infection with rheumatic heart disease in latent labour, posted for emergency LSCS. Thorough pre-anaesthetic evaluation was done to assess patient’s ability to respond to physiological challenges encountered intraoperatively. Patient presented to the hospital with complaints of breathlessness and active varicella infection for 2 days. Patient had not been diagnosed with any other co-morbidities prior to this. In view of breathlessness, ECG, chest X-ray and 2D echo was done and patient was found to have RHD with sever MS, sever TR, sever PAH with preserved EF of 60%.  General anaesthesia was performed and patient was induced with thiopentone and fentanyl, patient was intubated with endotracheal tube, maintained with isoflurane, vecuronium. Patient was started on inj. Furosemide 0.5ml/hr intra op. Blood gas analyses done intraoperatively to correct metabolic, electrolyte disturbances, blood sugars monitored for glycemic control, adequate volume replacement was done with crystalloids. Post-operatively patient was shifted to ICU with endotracheal tube for postoperative elective ventilation, extubated the following day.  Conclusion: Numerous hemodynamic factors must be evaluated to determine the suitable anaesthesia for caesarean section in sever RHD patients. Both regional and general anaesthesia have been administered for caesarean sections in parturients with varicella. When selecting anaesthesia technique, its essential to thoroughly weigh the risk and benefits of general anaesthesia and central neuraxial block