||Presented is a case study involving the anesthetic management during elective surgery for a patient prescribed rasagiline, a second generation monoamine oxidase (MAO) type B inhibitor for Parkinson's disease. Anecdotal reports have recommended discontinuing MAO inhibitors 2 to 3 weeks before elective surgery, however rasagiline was not discontinued and elective surgery proceeded. Although recent literature supports uneventful anesthesia for patients on MAOIs, this case presents hemodynamic fluctuations and discusses the potential causes and treatments for these fluctuations. This case appears to be the only recent publication on second generation MAO type B inhibitors for the treatment of Parkinson's disease and hemodynamic instability. Conclusions are that anesthetic plans must be tailored to blunt the SNS response, avoid drug interactions, provide quick intubation technique, and whenever possible, implement regional anesthesia.