Epidural anesthesia is usually preferred as an adjunct to general anesthesia in patients undergoing intra-abdominal operations. However, preferring epidural anesthesia solely in selected patients with poor geneal health, severe cardiopulmonary disease or high risk may protect the patients against the possible adverse effects of general anesthesia. This type of anesthesia should be performed to carefully selected patients by experienced anesthetists since it may cause adverse effects, including death. In this case report, we would like to share technical aspects and follow-up of epidural anesthesia in an old patient with high risk and severe pulmonary disease who underwent an upper abdominal operation.