Ankylosing spondylitisis a chronic, progressive autoimmune inflammatory disorderaffecting the musculoskeletal system, can have large spectrum of underlying comorbidities. The multisystem involvement with Ankylosing spondylitis and Parkinson’s disease has its own characteristic involvement of organs. Here is a case report of association of Ankylosing Spondylitis and Parkinson’sdisease with multiple comorbidities involving various other systems and anesthetic management of the same when he was scheduled for thoracic spine surgery for D9-D10 fracture under neuro-navigation in a prone position.