Complications which were related either to radical vulvectomy or to lymphadenectomy have mostly developed in post operative period. Here, we report an intra-operative cardiac arrest case during radical vulvectomy which is under combined spinal and epidural anesthesia. A 78 year-old female patient underwent radical vulvectomy under spinal anesthesia with a diagnosis of vulvar cancer. Intraoperative cardiac arrest developed and after immediate cardio-pulmonary ressusitation, sinus rhythm was restored. Cardiac arrest due to spinal anesthesia is a rare complication with the incidence of 0.063%. Despite, vulvar surgery is known as a relatively safe procedure for complications like cardiac arrest, maximum care should be given both before and during the operation. It can be descriced as "once in a life" experience for a surgeon and instant decisions for the management of this condition will be life saving or mortal.