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Bone cement implantation syndrome is a known cause of intraoperative morbidity and mortality in patients undergoing cemented arthroplasty. It is a rare but potentially fatal complication. A case of elderly female patient is reported who developed this complication during hemi arthroplasty of right hip. Within a few minutes of cementation, she developed severe hemodynamic derangement and shock with hypoxemia. Aggressive and early resuscitative measures led to a favorable outcome. Risk factors, etiopathogenesis and management of this condition are discussed in brief.