Idiopathic pulmonary hemosiderosis (IPH) is a rare disease with major anesthetic implications, as it is characterized by recurrent life-threatening alveolar hemorrhage, fibrosis and restrictive lung disease. IPH anesthetic management case reports are scarce. The case of a child previously diagnosed with IPH, which was candidate for an elective urologic procedure under general anesthesia is presented in this paper. We describe our experience and anesthetic approach, with particular emphasis on the airway approach and management, and highlight possible contributions for future similar cases.