We report the anesthetic management of ventricular dysrhythmia and unstable hemodynamics in a chronic alcoholic patient with hypokalemia during an emergency subdural hemorrhage operation. We discuss the pathophysiology, clinical presentation, and possible causes of hypokalemia. Chronic alcoholism, head injury, or metabolic alkalosis might have caused hypokalemia in our patient. Methods to manage hypokalemia, namely monitoring, drug administration, and ventilation strategies, are also reviewed and discussed.