Catel Menzke syndrome is a rare congenital bone disorder characterized by clinodactyly and bilateral hyperphalangy of the Index fingerwith Pierre Robin sequence (glossoptosis, micrognathia, and cleft palate). Frequently reported with valvular heart defects like ventricular septal defect (VSD), and Patent ductus arteriosus (PDA).(1) This case report reviews major anaesthetic challenges and successful perioperative management of a rare syndromic pediatric patient undergoing orthopaedic surgery.