Robotic surgeries demand challenging positioning and anaesthetic management, but laparoscopic prostatectomy requiring steep Trendelenburg position for the prolonged duration is unusually documented. An elderly patient underwent radical prostatectomy in steep Trendelenburg position by laparoscopic approach with surgery lasting more than six hours duration. The postoperative recovery was complicated by the development of cerebral, ocular and airway edema apart from hypothermia. The perioperative complications required intensive-care unit care with prompt management of the airway and cerebral oedema along with elective overnight ventilation. The patient went home without any neurological or respiratory sequelae on the fifth postoperative day.