Regional anesthetic technique for a patient with Noonan syndrome and abnormal peripheral nerve imaging on ultrasound. Noonan syndrome is a rare genetic disorder involving pathologic changes to multiple organ systems, including chronic pain, posing a challenge to safe and effective anesthesia and analgesia for patients undergoing surgery. Abnormal peripheral nerve anatomy including nerve fascicle and root hypertrophy has been described in patients with Noonan syndrome (1, 2). Little published describing the safety and efficacy of regional anesthetic techniques in this population.We present a case of successful and safe post-operative regional anesthesia using a continuous femoral nerve catheter in a patient with Noonan syndrome found to have significant peripheral nerve hypertrophy on ultrasound.