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This paper presents a case of acute respiratory failure after a successful Ultrasound guided supraclavicular brachial plexus block. Through this report we wish to highlight the importance of a thorough pre-operative assessment to identify high risk patients and close monitoring after the block for such complications to reduce adverse outcomes. Reducing the local anesthetic volume, ultrasound guided techniques and infra-clavicular or axillary brachial plexus blocks should be considered in highdoi:10.15761/jaa.1000110 fatcat:f6eue4iqpjgp7icctuztlw7shy