Myasthenia gravis is relatively common in young women and therefore sometimes associated with pregnancy. Since pregnancy influences the course of the myasthenia gravis, and the drugs used for its treatment may influence gestation, the obstetrical management of myas-thenic patient merits special consideration. In myasthenia gravis, it is generally thought that the anesthesia of chice is regional anesthesia during vaginal delivery and general anesthesia during Cesarian section. But in Cesarina section for a pregnant myasthenic with pulmonary disease, epidural or subarachnoid block may be preferable to avoid postoperative hazards. We performed epidural anesthesia with lidocaine in a 39-year-old elderly primigravida myasthenic with COPD and obtained good intra and postoperative results.