Takayasu Arteritis (TA) is a diffuse arteriopathy and involves aorta and its branches. We present strangulated inguinal hernia case with TA scheduled for emergency laparotomy. Case Report: A 22-year-male, with TA having multiple stenotic and occlusive vascular lesions was scheduled for emergency laparotomy. He was earlier hospitalized for accelerated hypertension, CHF and hypertensive encephalopathy. On examination, blood pressure was 190/50 mm Hg. Left radial, dorsalis pedis, femoral and left carotid arteries were not palpable and bruit was present in the right carotid artery. In the operating room, standard monitors were attached. Right radial artery cannulation was done.