A 48-hour old Holstein heifer calf presented on emergency to Cornell’s Equine and Farm Animal Hospital on for signs of colic and inappetence of 12 hours’ duration. The calf was brought to surgery, where atresia coli was identified and corrected with an end-to-side anastomosis to the descending colon. Following surgery, the patient experienced an anesthetic complication characterized by severe hypothermia, moderate hypercapnia, and moderate acidemia. The patient was medically managed for cerebral edema. After apparent recovery from the anesthetic complication, a focal seizure event progressed to a grand mal seizure, characterized by opisthotonus, collapse, paddling, and horizontal nystagmus. This event was attributed to a lidocaine toxicity. The patient’s lidocaine constant rate infusion was discontinued, and she displayed no further seizure activity. The patient continued to recover uneventfully until being discharged to the care of her owners 5 days post-operatively. This paper reviews the clinical presentation and surgical correction of atresia coli in calves. Particular attention is given to hypercapnia and lidocaine toxicity as postoperative complications.