Wilms tumor (WT), also called nephroblastoma, is a solid, malignant renal mass that can sometimes grow so large it spreads outside the kidney and invades other structures. Most experts recommend complete tumor resection as a primary intervention. The clinical manifestations caused by the WT most significantly hypertension, can appear as a barrage of pathophysiological events to the nurse anesthetist. The case presented involves an 9 month old infant who underwent a radical nephrectomy because of a WT. Case was conducted successfully under epidural anesthesia using clonidine as a adjuvant to bupivacaine.