A 26 year old, female presented to EMD in severe respiratory distress. Patient had history of breathlessness since past one month with h/o intrauterine death 1month back .On further investigation it was found that anti acetylcholine receptor antibody was above normal limits and was started on cholinesterase inhibitors, initially patient showed signs of improvement but later patient condition worsened and patient was diagnosed with Myasthenia gravis in crisis. Patient was started on pulse steroid therapy but patient did not show significant response, patient attenders were advised for IVIg but they could not afford the same, later patient was transferred to a center with plasmapheresis facility where plasmapheresis was done and now patient doing well and is on oral cholinesterase inhibitors. Keywords: Myasthenia crisis, anti-acetylcholine receptor antibodies