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Fontan procedure is a palliative surgery done for patients born with single ventricle physiology. An understanding of the hemodynamic alterations in such a patient is important for successful perioperative management. Added to this challenge is the Craniopharyngioma which constitute about 2-6% of all the intracranial tumors in pediatric age group. Management of craniopharyngiomas in children is very challenging for anesthesiologist, owing to the developing neurological and physiological status, handling of a growing brain, perioperative endocrinological complications, and the management of hydration. We discuss the anesthetic considerations for a 6 years old female with Fontan circulation going for craniopharyngioma resection under general anesthesia.

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