von Recklinghausen disease is a type I neurofibromatosis originating from the nervous system. In this syndrome, there is abnormal deposition of neural tissue in the nervous system, endocrine system, visceral structures, and skin. We report the anesthetic management of a 31-year-old female patient with multiple thorax deformities who was diagnosed as von Recklinghausen disease. The patient was admitted to the Plastic and Reconstructive Surgery Department because of a huge subcutaneous neurofibroma on her right upper extremity. General anesthesia was considered a high risk for this patient on the basis of her laboratory results and physical findings. We planned brachial plexus block with axillary approach under sedation. The subcutaneous neurofibroma was not in contact with the nerve sheath; thus, regional anesthesia was our preference for this particular patient.