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Churg–Strauss syndrome (CSS), also referred to as eosinophilic granulomatosis with polyangiitis, is characterised by asthma, peripheral and tissue eosinophilia, extravascular granuloma formation and vasculitis of multiple organ systems. Patients with CSS have higher risk for hyper-reactive airway disease. Administering general anaesthesia in such patients may be deleterious as it requires airway manipulation, use of muscle relaxants some of which are associated with release of histamine and use of anti-cholinesterases which can cause bradycardia, increased secretions and bronchial hyper-reactivity. We report a case of a 36-year-old male with known CSS presented with umbilical hernia for mesh repair which was managed with regional anaesthesia.