Recent studies have suggested an association between Pulmonary Arterial Hypertension (PAH) and thyroid disease. This combination is however rare during pregnancy. Here is a case of uncontrolled hyperthyroidism with severe PAH presenting during the third trimester. Due to impeding fetal distress patient was taken for delivery via caesarean section. Under a cover of Propylthiouracil (PTU) and beta blockers, epidural anaesthesia was given to avoid substantial hemodynamic variations which may induce sudden right ventricular insufficiency. Uneventful intraoperative and postoperative course ensured good maternal outcome.