Introduction: Kyphoscoliosis, a condition characterized by forward and lateral   bending of the thoracolumbar spine. The most common cause of kyphoscoliosis  is idiopathic, which occurs in 70% of the population. The secondary causes may include neuromuscular, congenital, or traumatic. Patients with thoracolumbar
kyphoscoliosis present unique challenges to anaesthesia.  Case Report: A 72 year old male, with kyphoscoliosis diagnosed with left  sided complete indirect inguinal hernia was posted for hernioplasty. He was a known case of Alzheimer’s disease. On examination vitals were stable. Airway  examination showed Mallampati grade 4. An examination of the spine revealed a lateral curvature along with thoracolumbar kyphosis. Blood and routine investigations were within normal limits. The surgery was planned under spinal
anaesthesia. On the day of surgery, the patient was shifted to the operation theatre, standard monitoring was ensured perioperatively. Patient was given subarachnoid  block through paramedian approach. Intra operative vitals were stable. Standard monitoring was continued in post operative care unit for 30 mins. There was no
surgical or anaesthetic comp  lication.Conclusion: When both the airway and spine are involved in the disease process  the anaesthetic options are limited and technically diffcult. Subarachnoid block  with proper   preoperative planning can be a useful technique of providing safe and  effective anaesthesia in patients with severe thoracolumbar kyphoscoliosis.