IMAGe syndrome (OMIM 300290) is a rare multisystem disorder that has a broad 
phenotypic presentation. Though variable, this disorder mainly consists of 
Intrauterine growth retardation, Metaphyseal dysplasia, Adrenal hypoplasia 
congenita, and Genital abnormalities. Patients with IMAGe syndrome present as an 
uncommon yet important challenge for dentists and anesthesiologists due to their 
wide range of dysmorphic facial features, adrenal insufficiency, electrolyte 
imbalances, and need for steroid replacement. The purpose of this case report is 
to describe the successful anesthetic management of a pediatric patient 
diagnosed with IMAGe syndrome who presented for full mouth dental 
rehabilitation.