Grave’s disease is an autoimmune condition leading to hyperthyroidism which typically presents with a combination of hyperthyroid features. It can lead to a number of haematological alterations and pancytopenia is one such rare complication. The initial management of Grave’s primarily resolves around usage of antithyroid drugs like carbimazole. But a common adverse effects of these drugs is marrow suppression. Here we describe a case of Grave’s disease who presented with respiratory tract infection and had worsening pancytopenia. Extensive workup failed to identify any explanation for the pancytopenia other than the thyrotoxic state itself. She could not be initiated on antithyroid medications initially and was kept on beta blockers and steroids. GM-CSF analogues like filgastrim and romiplostim were used to bridge the phase of worsening pancytopenia. After resolution of infection and borderline increase in blood counts post therapy with GM-CSF analogues she was started on carbimazole with subsequent radioiodine ablation. Her pancytopenia improved drastically after achievement of euthyroid status. In this case report we highlight the management challenge posed by worsening pancytopenia in a thyrotoxic patient in the clinical backdrop of infection and some therapies which can be used to bridge over this difficult situation