Pregnancy is associated with increased coarctation- associated complications. We report the successful management of emergency lower-segment cesarean delivery in a patient with coarctation of aorta. A par- turient at 34 weeks of gestation of a twin pregnancy with uncorrected coarctation of aorta was taken for emergency lower-segment cesarean delivery to be performed using epidural anesthesia. A mixture of lignocaine (lidocaine), bupivacaine, and fentanyl was administered epidurally. In view of unsatisfactory motor action, general anesthesia had to be adminis- tered. However, because of sufficient analgesia due to the epidural drugs, optimal hemodynamic control was achieved. A combination of general and epidural anesthesia minimizes adverse effects of coarctation of aorta, with improved maternal and fetal outcomes.