Performing orthopaedic surgery in beach chair position (BCP) is a common procedure in Denmark. In this case report we present a patient, who underwent standard procedure with no variations according to the general anaesthesia. The arterial blood pressure after entering BCP and during surgery was acceptable. In the recovery phase the patient did not gain full consciousness, his blood pressure turned high and he developed seizures. A. cerebri media infarction was identified, and severe brain damage was the consequence. We question the rationale for using BCP as well as the use of phenylephrine for the cerebral hypoperfusion.