Takayasu's arteritis, also known as Takayasu's syndrome, is a chronic inflammatory disease, which primarily affects large vessels including the aorta and its main branches. The anesthetic management for the patient presenting with Takayasu's arteritis is complicated by the multiple organ systems affected by the disease. A 59-year-old Chinese female with the diagnosis of Takayasu's arteritis presented with severe progressive occlusion of the thoracic and abdominal aorta and bilateral renal artery stenosis, necessitating an extra-anatomic aorto-aortic bypass and bilateral aorto-renal bypass. The patient tolerated the operative procedure without any untoward events. This case report discusses the pathophysiology of Takayasu's arteritis and the anesthetic management of aortic surgery specific to this particular disease process.