ABSTRACT A 45 year old male with no known medical co morbidities was posted for tension band wiring for right fracture patella. On routine preanaesthetic evaluation , patient was diagnosed to have Brugada syndrome based on the typical ECG findings of coved ST elevation of >2mm in V3 and V4 followed by a negative or flat ‘T’ wave and cardiac opinion confirming the diagnosis of Brugada syndrome. These patients are at high risk for malignant dysrhythmias and cardiac arrest. Drugs causing bradycardia like neostigmine, beta blockers, and temperature changes during general anesthesia can precipitate malignant dysrhythmia, hence we opted for regional anaesthesia technique for this patient. Anticipating the possibilitity of cardiac dysrhythmias, defibrillator and emergency drugs were kept ready. Epidural anaesthesia was given with the catheter placement at L3-L4 level. Lignocaine with adrenaline 2% was chosen, which as per literature was considered to be safe. Bupivacaine which is cardiotoxic and a precipitant of cardiac arrest in these cases was avoided. Lignocaine with adrenaline 2% was given in graded doses to a total volume of 14 ml to achieve a blockade of L1. Patient was hemodynamically stable throughout the procedure. Post operative pain managed with intravenous paracetamol and tramadol. It is very important for the anaesthesiologist to be familiar with anesthetic management of Brugada syndrome, which is diagnosed in an asymptomatic patient presenting for incidental surgery as in our case or these patients present for anaesthesia for the treatment of the syndrome by implantable cardioverter defibrillator insertion(ICD).