Introduction: Xylocaine or normal saline along with 1:2,00,000 adrenaline is commonly used for presurgical infiltration. Local infiltration containing adrenaline often causes cardiovascular side effects which may be variable ranging from tachycardia, hypertension, arrhythmias and hypotension in some cases. Case Report: We report a case of 54 year old female a known case of hypothyroidism, dyslipidemia with current admission diagnosis of deflected nasal septum, bilateral nasal polyposis and chronic sinusitis who underwent Functional Endoscopic Sinus Surgery (FESS) and septoplasty. Preprocedure the surgical site was infiltrated with 1:2,00,000 freshly prepared xylocaine with adrenaline solution. Subsequent to this infiltration patient developed hypotension which was transient in nature and responded to intravenous fluid bolus. Conclusion: The infiltration of xylocaine with adrenaline may lead to ß2 receptor activation leading to skeletal muscle vasodilation and decrease in preload leading to hypotension. This was the most probable attributable cause of transient hypotension in our case although this hypotensive effect is not seen commonly.