A difficult airway in an ankylosing spondylitis patient may be a nightmare for ananaesthesiologist. We report a case of a 48–year–old man who was scheduled for closereduction and internal fixation of left proximal tibia fracture. He was diagnosed with ankylosing spondylitis with multiple extra–spinal joint involvements. He had CAD and hypothyroidism with a no history of exposures to any kind of anesthesia. He was a chronic tobacco chewer and had a difficult airway. He was managed successfully with sciatic and femoral block with the help of nerve locator.