A patient with McArdle disease underwent bowel surgery with general anesthesia and was successfully managed. McArdle disease is a rare skeletal muscle disorder affecting approximately 1 in 100,000 people. McArdle disease, also known as type V glycogen storage disease, is an autosomal recessive inherited condition caused by a missing or nonfunctioning enzyme called myophosphorylase C. This phosphorylase is the enzyme responsible for making glucose for energy. Individuals suffering from McArdle disease have muscles that cannot properly metabolize energy and may experience fatigue and failure during strenuous activities. When a patient with McArdle disease presents for any surgical procedure, a variety of anesthesia implications should be discussed and incorporated into the overall management of his or her care. Careful attention to adequate fluid management, appropriate neuromuscular blockade choices, normothermia maintenance, normoglycemia maintenance, blood pressure monitoring, and maintaining malignant hyperthermia precautions is critical to providing safe anesthesia to this unique patient population.