Introduction: Cervical spondylotic myelopathy is a degenerative condition resulting in the compression of the spinal cord. It leads to symptoms such as gait disturbances, hand clumsiness, neck pain. The presence of poliomyelitis that causes motor neuron damage and muscle atrophy adds further complexity to the management of cervical spondylotic myelopathy. Case Report: A 64 year-old male diagnosed with cervical spondylotic myelopathy was posted for limited cervical laminectomy. He came with complaints of neck pain radiating to left upper limb and left upper limb weakness for 4 months. He was a known case of poliomyelitis with right upper limb paralysis since childhood. He was short in stature. Airway examination showed Mallampati grade 2. Upon neurological examination his motor power in both lower limbs was 5/5, in right upper limb 0/5, left upper limb 3/5 with no sensory deficit. Blood & routine investigations were within normal limits. Standard monitoring was ensured perioperatively, Patient was induced as per standard anaesthesia protocol. Patient was intubated with manual inline stabilization with Video laryngoscope. Then patient was log rolled to the prone position on the operating table with pressure point precautions. Intra operative vitals were stable. Anaesthesia was maintained with isoflurane, O2 and N20. Peri operatively multimodal approach of analgesia was employed. Patient was extubated and neurological assessment was done. Standard monitoring was continued IN the post aesthetic care unit for about 1 hour. There was no surgical or aesthetic complications. Conclusion: This case illustrates the complexity of anesthetic management in patients with both cervical spondylotic myelopathy and poliomyelitis. Meticulous  planning, including careful airway management and patient positioning, is critical to avoiding further neurological impairment. A tailored anesthetic approach, including preoperative evaluation and intraoperative vigilance, ensured a successful outcome in this patient.  Key Messages: Two challenges we faced in our case was upper limb paralysis due to poliomyelitis, we had to secure IV canula in the femoral vein and airway challenge due to spondylitis changes in cervical spine. Airway was accessed with inline stabilisation with the use of video laryngoscope. Electromyography or motor evoked potentials are desirable in this sort of patients where poliomyelitis and the changes due to spondylitis are to be monitored after surgical intervention.