Superior vena cava (SVC) syndrome can present many complications and anesthetic risks the most important being hemodynamic collapse and airway compression; which can be fatal upon induction of anesthesia [1-4]. The SVC provides venous drainage from the head and upper extremities. These vessels are easily compressed most commonly from an extrinsic tumor specifically a bronchogenic carcinoma or lymphoma [5]. As blood flow to the right atrium becomes obstructed alternative pathways must be established to allow venous return to the heart. Upper body venous pressure can become significantly elevated. This results in the clinical signs and symptoms of venous congestion including cough or headache even swelling of the arms and face as well and engorgement of the mucous membranes involving the upper airway [5]. In general these symptoms may worsen when the patient is placed supine. The venous obstruction tends to decrease blood return to the right ventricle lowering preload and produce swelling of the upper airway leading to orthopnea. We report the cancelation of an upper GI endoscopy under GA due to SVC syndrome.