Saul-Wilson syndrome, also known as microcephalic osteodysplastic dysplasia, is a rare type of dwarfism with significant anesthetic considerations. The genetic defect is associated with nearly uniform micrognathia, odontoid hypoplasia, and possible cervical spine instability that contribute to potentially increased risk of airway complications. Herein, we describe the anesthetic management of a 2-year-old child with Saul-Wilson syndrome.