Scoliosis is a complex deformity of the spine with lateral curvature and rotation of the thoracolumbar vertebrae leading to rib cage deformity. The goals for surgical treatment are to prevent progression, improve alignment and balance, and to avoid negative outcomes of the natural history of the disease without introducing iatrogenic complications. This chapter presents a case study of a 16-year-old female presented for posterior spinal instrumentation and fusion from T4-L2. The possibility of postoperative facial swelling and the remote chance of postoperative mechanical ventilation were also discussed. The most common form of scoliosis encountered is adolescent idiopathic scoliosis followed by neuromuscular scoliosis and their management can be quite different. Despite modern technology, scoliosis still carries a small but grave risk of mortality and morbidity. The key for an uneventful anesthetic is proper planning and knowledge of potential complications in order to avoid them.