Here we are presenting anaesthetic management of 61-Year-old male patient with Cardiac Resynchronization Therapy Defibrillator (CRTD) in situ, posted for Open Reduction Internal Fixation (ORIF) of left tibia Fibula, without interfering in the function of CRT defibrillator.Right selection of mode of anesthesia and changing the CRTD mode into asynchronous one are few of all the important factors that could be practiced Perioperative care in CRTD implanted patients. General anesthesia is avoided and Sab-Arachnoid Block anaesthesia causing sympathetic blockage to avoid hypotension should be preferred. Patient was preoxygenated and premedicated with 2 mgbutorphanol and 1 mg midazolam following which modified rapid-sequence induction was done using 100 mg propofol and 50 mg rocuroniumintaveously. Maintenance of anaesthesia was done with oxygen, nitrous oxide, isoflurane and rocuronium. Patient surgery completed successfully without any postoperative complications.