Background: Thyrotoxicosis associated with molar pregnancy is rare to see, and anesthesia management of such patients for the emergency procedure is extremely challenging. Case description: A 22-year-old primigravida with 17 weeks of amenorrhea presented with bleeding per vaginum and pain abdomen, diagnosed as molar pregnancy, posted for emergency suction evacuation. Primary examination and lab investigation showed features of thyrotoxicosis, and the Burch–Wartofsky score was highly suggestive of an impending thyroid storm. The endocrinologist advised the evacuation of molar pregnancy as it is the definitive management of thyrotoxic state in this condition, and optimum stabilization after initiation of an antithyroid drug is still not known. The patient was given preoperative β-blockers and steroids. The suction evacuation was done under low-dose spinal anesthesia successfully. The patient was symptomatically better and discharged after 1 week. Conclusion: Knowledge of dangerous complications of molar pregnancy and safe anesthesia choices are important for an anesthesiologist for successful perioperative management of such patients.