The present study aims to describe the anesthetic management of a patient with Down syndrome in connection to the degree of difficulty in orotracheal intubation and the associated risks of general anesthesia. The established diagnosis was subocclusive syndrome, requiring an emergent surgical intervention. Preoperatively, the patient was stabilized, and secondly, a series of clinical and paraclinical investigations were carried out in order to assess the best management of the anesthetic procedure. Risk factors were identified, including ischemic heart disease, grade II obesity, hyperglycemia, patient's old age and marked mental retardation. The results of examinations that were carried out showed that the degree of difficulty of orotracheal intubation was low. Finally, the preoperative assessment indicated that the most appropriate approach for this patient was to perform a general anesthesia with endotracheal intubation. However, special care was given to the anesthetic and postoperative condition of the patient in order to lower the possible complications of the surgical intervention.