We present a case of a 23-year-old male with Moebius syndrome admitted with sigmoid volvulus. Moebius Syndrome is a very rare complex congenital disorder characterised by uni- or bilateral facial paralysis resulting in orofacial abnormalities that in some individuals make tracheal intubation very difficult. In the present case, complications during the anaesthetic procedure caused a fatal outcome for the patient, as difficulties intubating was followed by an unexpected circulatory collapse, which could not be counteracted in the current setting. The case emphasises the importance of handling patients with Moebius Syndrome and other patients with a difficult airway with utmost caution during anaesthetic care, particularly in the emergent setting where other complications might be present. A thorough preanaesthetic evaluation with specific attention to airway management and circulatory status is mandatory and all measures must be taken to optimise patient safety.