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Complete heart block is a medical emergency managed by insertion of cardiac pacemakers. Most common reversible causes of AV (atrioventricular block) are drug induced, metabolic and endocrine causes. The metabolic causes of AV blocks are hyperkalemia and hypermagnesemia. Hyponatraemia is the commonest electrolyte disturbance seen in intensive care patients, but it causing cardiac conduction defects is very rare and here we present a 60 year old female with third degree (complete) AV block caused by hyponatraemia who reverted to sinus rythm after correction of hyponatraemia.