A 46-year-old woman with antiphospholipid syndrome (APS) underwent an emergent laparotomy. The symptoms and signs of APS are reported to be thrombosis, habitual abortion, thrombocytopenia and biological false positive (BFP) for syphilis' tests. Clinical symptoms are based on hypercoagulation of blood, while prothrombin time (PT) activity and activated partial thromboplastin time (APTT) are prolonged. Although we have selected general endotracheal anesthesia without epidural catheterization, we recommend that the regional analgesia is suitable for those APS patients with abnormality of coagulation. If PT and APTT differ from clinical symptoms, we have to think about APS and manage the patients carefully as APS.