Ankylosing spondylitis is a chronic inflammatory disease that characteristically involves the sacroiliac and spinal joints; less frequently other musculoskeletal articular structures, the eyes and the heart may be affected. A 49 year old male patient was admitted to our hospital to be operated upon for a periappendiceal abscess. The patient has been suffering from ankylosing spondylitis for 18 years and was unable to flex or extend his neck due to cervical and lumbosacral ankylosing spondylitis. Regional anesthesia was tried through L1-2 interspace, which was poorly defined radiologically, but neither a spinal or epidural block from both the lateral and midline were successful due to the bony resistance. Oral endotracheal intubation was performed with an #8 rubber shaped like a "hocky stick". The anesthetic problems of a patient with ankylosing spondylitis are discussed.