Anaphylaxis is a rare but potentially life-threatening complication of anaesthesia and surgery. The reported incidence ranges from 1 in 3000 to 1 in 20 000 anaesthetics, with case-fatality rates of approximately 3.8–4.0%^1,2. Recognition in the operating theatre is challenging, as cutaneous signs are often obscured and anaesthesia may blunt compensatory responses such as tachycardia. Although anaphylaxis typically causes hypotension, anaesthetic agents and surgical blood loss can aggravate or mimic this presentation. Consequently, perioperative anaphylaxis remains a major patient safety concern, underscoring the need for all theatre professionals to recognize the condition and initiate immediate treatment^.