Background: Congenital torticollis is a pathological condition involving an abnormal tilt and rotation of the head and neck, often due to dysfunction of the sternocleidomastoid muscle. While conservative treatment is typically effective in early stages, surgical intervention becomes necessary for refractory cases or when fibrosis develops. This report highlights the anaesthetic challenges and management strategies for a patient with congenital torticollis undergoing Ferkel's bipolar sternocleidomastoid muscle release. Methods: A 15-year-old female patient with cervical scoliosis, atlanto-axial subluxation, and a Mallampati Grade III airway underwent a detailed preoperative evaluation. Anaesthesia was induced with fentanyl, glycopyrrolate, and propofol, followed by succinylcholine for muscle relaxation. Intubation was achieved using video laryngoscopy to ensure optimal visualization. Maintenance anaesthesia included oxygen, nitrous oxide, 1% sevoflurane, and vecuronium. Ultrasound-guided superficial cervical plexus block with 0.25% bupivacaine was administered for postoperative analgesia. Results: The surgery, lasting two hours, was conducted with the patient in a supine position with careful head alignment. Despite airway challenges, successful intubation was achieved on the first attempt. Intraoperative and postoperative management ensured stable vital signs, adequate analgesia, and an uneventful recovery. Conclusion: This case underscores the importance of individualized anaesthetic planning in patients with congenital torticollis. Combining general anaesthesia with regional techniques enhances intraoperative conditions and postoperative outcomes. Video laryngoscopy proved invaluable in overcoming airway challenges, while targeted regional anaesthesia reduced systemic analgesic requirements.