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Paget’s disease (PD) of bone is a nonmalignant disease of unknown etiology involving accelerated bone resorption followed by deposition of dense, chaotic, and ineffectively mineralized bone matrix. It is frequently asymptomatic and the patient may present with symptoms depending on the bones involved. We are reporting perioperative management of a case of Paget’s disease with dilated cardiomyopathy for emergency orthopaedic surgery.