The antiphospholipid antibody syndrome (APS) is characterized by the presence of auto antibodies to phospholipids in association with in vitro prolongation of phospholipid-dependent coagulation tests, recurrent pregnancy loss, multiple thrombotic events, etc. Due to strong predilection for thrombosis in both the arterial and venous system, perioperative thromboprophylaxis for APS patients is very important to avoid catastrophic major cardiovascular complications. We experienced general anesthesia for a total abdominal hysterectomy in a 47-year-old patient diagnosed as having APS by a past medical history of deep vein thrombosis, fetal wastages, and laboratory confirmation. Pre and postoperative management for hypercoagulability was done with oral warfarin and low dose heparin. To prevent intraoperative thrombosis, we maintained an activated clotting time (ACT) over 200 seconds by heparin 3000 U injection, applied antithrombotic stockings, and tried to avoid dehydration, hypothermia and infections.