A B S T R A C TDouble outlet right ventricle (DORV) is a rare cardiac condition in which the heart demonstrates single ventricle physiology. The management of these patients depends upon the presence or absence of pulmonary stenosis. They can present as congestive cardia failure on one end and as cyanotic disease on the other extreme. We present a case of DORV without pulmonary stenosis for cesarean section and highlight specifi c management issues in these patients.