Polycythemia vera is a rare case confronted in dentistry with scarcely available case reports. Hence a scrupulous knowledge of it is inevitable. It is a myeloproliferative disorder characterized by excessive proliferation of erythroid elements, granulocytic and megakaryocytic cells. Here, the blood viscosity increases leading to menace of thrombosis. The medications often used include cytoreductive agents like hydroxyurea 500mg to reduce the leukemogenic risk and Ecospirin 75mg to lessen the thrombotic risk in artery. A 44-year-old male patient reported with a history of pain over the upper right back tooth region since two weeks. The pain was sudden in onset sharp intermittent non radiating aggravates on taking cold fluids and relieves by itself. He also complained of food lodgement around the same site. He is a known case of absolute polycythemia in the last 8 months, undergoing treatment with Ecospirin 75mg and frequently subjected to phlebotomy. A synchronized endeavour by hemato-oncologist and dentist is required for dental treatments, peculiarly invasive therapies, in such patients. Further, an awareness of the medication used for the treatment is unavoidable.