Patient with scoliosis for major surgeries like Total abdominal hysterectomy present challenges for anaesthesia owing to long surgery duration, pulmonary complications, Intubation in case of general anaesthesia; And un-predictability of sensory blockade in case of neuraxial anaesthesia. In this case, a 56-year-old female, with Thoracic scoliosis, presenting complaints of abnormal uterine bleeding, diagnosed with multiple uterine fibroids, posted for Transabdominal hysterectomy decided to take under neuraxial anaesthesia by assessing risk benefit ratio. The anaesthetic management must address intraoperative hemodynamic stability and post operative analgesia, which achieved successfully in this case. This case highlights importance of preoperative assessment, imaging and planning in managing patient with scoliosis for major surgeries. Key Messages: Thoracic scoliosis is condition with multisystemic involvement, which can cause difficulty in induction, maintenance of anaesthesia, and postoperative outcome in patients posted for major surgeries. Hence selection of anaesthetic technique should be appropriate.