Vagally-mediated reflex bradycardic responses such as trigeminocardiac reflex during nasal surgery has been previously reported [1]. This disturbance occurred due to profound parasympathetic stimulation which can cause intense bradycardia and to some extent resultant in asystole. The afferent pathway of these reflexes is mediated by any of the branches of the trigeminal nerve, and the efferent pathway is via the vagus nerve. The reflex is one of the subtypes of Trigemino-Cardiac Reflex (TCR), but it is not well-described as the commonest subtype of TrigeminoCardiac Reflex (TCR) which is the oculo-cardiac reflex. It is rarely encountered during nasoendoscopy with the reported incidence of only 0.16% [2]. Case Report A 36-year-old gentleman underlying obstructive sleep apnea, had underwent modified cautery-assisted palatal stiffening operation, uvulectomy and septoturbinoplasty a week earlier came for follow-up assessment. He was generally well and upon nasoendoscopy, noted presence of crusting in the left nasal cavity. When we were about to remove the crusts with the tilley forceps, under endoscopic view, the patient suddenly became less responsive, cold clammy and pale. Vital signs assessment revealed blood pressure of 50/32 mmHg and heart rate of 46 Beats per Minute (bpm). His oxygen saturation otherwise 100% under room air and his random blood sugar was 8.7 mmol/L. He was brought to the treatment room and one pint of normal saline was given. Immediately, he regained his consciousness and his blood pressure picked-up to 101/67 mmHg and heart rate of 60 bpm.