A complete pre anaesthetic check up is imperative in all patients of all age groups. However often, due to lack of appropriate equipment, blood pressure recording is omitted in paediatric patients. The occasional patient may then present with undetected uncontrolled hypertension and manifest haemodynamic instability perioperatively with a consequence of increased morbidity and mortality. This case report highlights the importance of blood pressure measurement in patients of all age groups presenting to the pre anaesthetic check up clinics.