Patient with Tetralogy of Fallot (TOF) may 
sometimes present for noncardiac surgery. These patients 
may have lots of other congenital anomalies, which may 
need repeated surgeries for their correction. Anaesthetic 
management in this sort of cases for noncardiac surgeries 
may pose a real challenge to the anaesthesiologists 
because of the high incidence of perioperative 
complications. Cyanotic spell is one among them. 
Cyanotic spells are usually managed by drugs. But there 
is report of use of non-pharmacological measures also. In 
this case report we present successful management of the 
intraoperative cyanotic spell with intravenous fluids and 
blood.