Background: Patients with Evan syndrome are a challenge to anesthesiologists due to the risk of thrombocytopenia,bleeding during airway management and associated risk of haemmoraghic complications. Case presentation: We present anesthetic management of a 50–year–old Indian lady with secondary Evans syndrome for elective open splenectomy under General Anaesthesia. Conclusion: patient with Evan syndrome can be managed with meticulous preanesthetic evaluation, a definitive anesthetic managment with special considerations to risk of airway bleed, thrombocytopenia, systemic organ involvement and perioperative steroid replacement.