This report describes the noncardiac, nonobstetric surgical case of a 29-year old woman with idiopathic pulmonary arterial hypertension. To safely manage a patient with pulmonary hypertension, the anesthesia provider must have a thorough understanding of the disease and associated risks. This case study briefly summarizes the surgical case and then discusses history, current classifications, epidemiology, pathophysiology, contemporary treatments, and basic anesthetic management related to pulmonary hypertension.