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Bilateral radial dysplasia is a rare condition and usually associated with familial malformation syndromes and spectrum of cardiac anomalies. These patients often require corrective orthopedic surgeries in early age. Radial dysplasia associated with cardiac abnormalities is particularly seen in certain syndromes such as Holt-Oram (HOS) syndrome and TAR (thrombocytopenia, anemia, and radial aplasia) syndrome. We report a successful management of twelve months old male child with rare combination of bilateral radial dysplasia with isolated patent ductus arteriosus (PDA), for corrective orthopedic surgery. A comprehensive approach, which includes an extensive preoperative evaluation and pre-defined perioperative hemodynamic goals for PDA, plays a pivotal role in its perioperative management.