Introduction: Sacro-coccygeal Teratoma (SCT) is the most common tumor of the newborn, occurring in 1:35000-40000 live births. It is more common in females with a ratio of 3-4:1. The tumor is small and presents as a lump in the sacral region. It is the tumor located at the base of coccyx (tailbone). It is derived from two or three embryonic germ cell layers. Case Report: A one month 2 days old male infant's mother given complaints of abdominal distension and passage of green colour stools and vomiting. Baby was admitted in SNICU. CECT abdomen and pelvis showed multiple small round to oval cystic areas. It is in close relation with lower lumbar and sacrum from L5 to S3 level suggestive of ? primitive neuroectodermal tumor, ? Immature teratoma, ? Yolksac tumor, ? GIST. Baby was premedicated with Glycopyrrolate 0.01mg and fentanyl 5mcg. Started maintenance fluid of isolyte P 15ml/hr. Preoxygenation was done for 3 mins and Baby was induced with Thiopentone and Sevoflurane and intubation was normal with direct laryngoscope. Muscle Relaxation is achieved with Atracurium 1.3mg iv given as loading dose and 0.25mg was given as maintenance dose. Warmer is connected. Pressure points were padded and baby's eyes were covered properly with cotton rolls. Baby was shifted to SNICU with tube insitu.one day baby was ventilated and next day extubated after spontaneous trial and kept on nasal prongs with 2lts of O2. After uneventful post op recovery and utmost care, baby got discharged after 20 days. Conclusion: As most of the SCT tumors are benign in infants, it should be identified early and gets operated. The prognosis of this tumor is excellent in infants. Anaesthetic management includes specific considerations in this baby were fluid loss, posture and temperature control. Thus, early diagnosis, management of intra-operative blood loss, hypothermia and post-operative nursing can bring favourable outcome. Key Messages: Management of infant possess a challenge to the anaesthetist in terms of preparation, accessing a iv cannula, planning for anaesthesia, positioning, fluid and pain management. Our case presented with a Sacro-coccygeal teratoma with no neurological deficit, the challenges were securing of iv access and maintain the patient in prone position. Multidisciplinary approach was done with help of Paediatrician, Neuro surgeon and our team. A Successful outcome happened with the team work.