Extrapleural pneumonectomy is a radical and aggressive surgery for malignant pleural tumors. Anaesthesia management in these patients is highly a challenging task for anesthesiologists due to increased risk of perioperative morbidity and mortality. We present a case report of 45 year old female with spindle cell sarcoma for extrapleural pneumonectomy it represents our institution experience in anaesthesia care. An understand of the unique physiological consequences of this procedure,preoperative assessment of cardiopulmonary function,thoracic epidural, physiotherapy, high vigilance, team work, collaboration with surgeon helps to improve perioperative outcome of patients.