Pulmonary arterial hypertension (PAH) is a progressive disease characterised by significant morbidity and mortality. Intravenous (IV) epoprostenol (Veletri, Johnson & Johnson, US), a prostacyclin analogue, has been shown to improve exercise tolerance, PAH symptoms, haemodynamics and survival.1,2 However, there is a lack of data on feasibility and tolerability of this therapy in Singapore. A previous study examined the use of selexipag, an oral prostacyclin analogue, in a Singapore population.3 We aimed to describe the first Singapore experience of initiating and maintaining IV epoprostenol therapy for treating PAH patients in Singapore, and highlight the various issues and challenges encountered.