Patients with hypertrophic cardiomyopathy (HCM) pose a considerable anesthetic challenge as the outflow tract obstruction can be worsened by various conditions, which may be worsened by the concurrent occurrence of a difficult airway such as retrosternal goiter. Additionally, these patients pose a higher incidence of ischemic heart disease, which may further increase the risk of anesthesia and surgery. Successful anesthetic management in patients with HCM and goiter involves a multidisciplinary approach with the goal of maintaining stable hemodynamics with minimal LVOT obstruction, securing a definitive airway, and preventing postoperative complications. Here, we successfully managed a patient with HCM and retrosternal goiter posted for noncardiac surgery.