NN, an 86-year-old retired headmistress with undiagnosed hypertension had Austin Moore’s hemiarthroplasty of the right femur under spinal anaesthesia with sedation. Subarachnoid block was achieved with 2 ml of 0.5% isobaric bupivacaine. Intraoperatively she suffered severe hypotension for which she was managed successfully. Postoperatively she had urinary tract infection, which responded to treatment. The anaesthetic challenges encountered in her management and the perioperative considerations for geriatric anaesthesia are discussed.