Abstract Coenurosis is a parasitic disease affecting the central nervous system of small ruminants. This case describes the anaesthetic management of a ewe undergoing craniotomy for associated‐brain cyst removal. As small ruminants are food‐producing animals, there is limited access to veterinary medicinal products, and choosing an appropriate anaesthetic protocol is challenging. After premedication with detomidine (0.03 mg/kg intramuscularly) and butorphanol (0.1 mg/kg intravenously), anaesthesia was induced with lidocaine (1 mg/kg) and ketamine (2 mg/kg intravenously), and maintained with isoflurane in oxygen, using controlled mechanical ventilation. The animal was placed in sternal recumbency, with the head slightly elevated. A lidocaine incisional infiltration was performed, and dexamethasone (0.06 mg/kg intravenously) was administered. Vital parameters remained stable throughout anaesthesia, but moderate agitation was noticed at recovery, treated with butorphanol (0.05 mg/kg intravenously). While the ewe showed clinical improvement initially, its neurological status deteriorated in the following days, leading to euthanasia. Postmortem examination revealed intracranial haematoma.