Abstract Transposition of great arteries is a rare and serious congenital cyanotic disorder in which two main arteries leaving the heart are reversed or transposed. Transposition of the great arteries changes the way blood circulates through the body, leaving a shortage of oxygen in blood flowing through the heart to the rest of the body. These patients are at high risk of perioperative mortality due to ventricular dysfunction, chronic hypoxia, hypercyanotic spells, polycythemia and infective endocarditis [1]. Very limited studies are available regarding anaesthetic consideration in patients with uncorrected DTGA with other congenital cardiac defects like ventricular septal defect (VSD) and pulmonic stenosis. This case report highlights the anaesthetic challenges in an uncorrected transposition of great arteries along with other congenital cardiac defects for an emergency noncardiac surgery in a critically ill pediatric patient.