Abstract Cranial Meningocoele is a term which represents herniation of meninges and cerebrospinal fluid through the congenital defect in the cranium. Anaesthetic challenges in the management of neonates with occipital meningocoele include airway management and proper positioning of the neonate without pressure on the meningocoele sac so as to prevent rupture of the membranes. Associated congenital anomalies also can cause anaesthesia and procedure related complications. We report a case of 6 day old neonate with occipital meningocoele posted for MRI brain and the successful anaesthetic management.