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Abstract The perioperative anaesthetic management of a case of COVID-19 pneumonia with multiple systemic comorbidities, posted for unilateral below knee amputation and debridement of hand, poses a uniquely challenging scenario for the anaesthesiologist. We hereby report such a case which was managed successfully using ultrasound-guided popliteal and wrist block along with perioperative use of high flow nasal cannula, incentive spirometry and awake proning.