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Gastrointestinal stromal tumours (GISTs) are a rare subset of mesenchymal malignancy that may become diffusely metastatic and thereby present a unique range of perioperative challenges. We present the case of such a patient, a male in his 70s with metastatic GIST undergoing cytoreductive surgery. His perioperative course was notable for significant intraoperative blood loss secondary to persistent coagulopathy and refractory hypoglycaemia despite frequent monitoring paired with prompt intervention. These clinical complications were thought to be attributable to distinct characteristics of GIST, and our hope is to further contribute to the limited body of literature regarding the optimal anaesthetic care for these patients.