Topical application of adrenaline is commonly used in ENT (Ear Nose Throat) surgeries and some neurosurgical procedures such as sellar or suprasellar mass excision by transnasal route. Cardiac adverse effects such as arrhythmias are not commonly reported complication of topical adrenaline application by nasal packs. Here we present a case report of topical adrenaline induced ventricular tachycardia in a Craniopharyngioma patient posted for Transnasal transsphenoidal excision of lesion (TNTS) excision of lesion.