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Mitral valve prolapse (MVP) is a common valvular cardiac abnormality in the general population and is very rarely associated with Wolf Parkinson White (WPW) syndrome. These patients are prone for life threatening arrhythmias. Anaesthetics tend to change the electrophysiology of the atrio-ventricular conduction system and hence they tend to affect the behavior of the patient under anaesthesia. We present a case of mitral valve prolapse with WPW syndrome who underwent successful general anaesthesia for open nephrolithotomy.