Tehran University of Medical Sciences Archives of Anesthesiology and Critical Care 2423-5849 8 Supp. 1 2022 11 07 416 419 Begüm Gökdemir Department of Anesthesiology, Başkent University Ankara Hospital, Ankara, Turkey. Nedim Çekmen Department of Anesthesiology, Başkent University Ankara Hospital, Ankara, Turkey. Nazrin Zülfügarlı Department of Anesthesiology, Başkent University Ankara Hospital, Ankara, Turkey. Adnan Torgay Department of Anesthesiology, Başkent University Ankara Hospital, Ankara, Turkey. 2022 03 14 2022 04 24 Achondroplasia is a congenital autosomal dominant disease which has fibroblast growth factor receptor -3 mutation (FGFR-3). Anesthetic management of achondroplastic patients warrants special anatomical and physiological considerations because of important variations in the airway as well as the spine in regional techniques. In our case, 37-years-old male dwarf with achondroplasia has end stage renal disease (ESRD) and received cadaveric renal transplantation (RT). Preoperative assessment revealed the Mallampati score IV airway with a cervical instability, thoracolumbar kyphoscoliosis and spinal deformities. We aim to highlight anesthetic management of achondroplastic dwarf with difficult airway during operation. https://aacc.tums.ac.ir/index.php/aacc/article/view/502