Parkinson’s disease, a neurodegenerative disorder, affects approximately 1% of population older than 60 years. Patients with Parkinson’s disease with intractable symptoms often require placement of deep brain stimulator, conventionally known as brain pacemaker. Patients implanted with this device pose specific challenges to the anesthesiologist in view of the primary illness, possible drug interactions, risk of cerebral hemorrhage from anticoagulant therapy, and potential for device malfunction by electromagnetic interference during cardiac surgery. The authors describe perioperative management of a patient with implanted brain pacemaker who underwent aortic valve replacement at their institution.