Abstract: Intraoperative hypotension happens in everyday clinical practice. It was suggested to have a strong association with adverse postoperative outcomes. Hypotension prediction index (HPI) was developed to predict intraoperative hypotension (mean arterial pressure <65 mmHg) in real time. However, pressure autoregulation also plays an important role in maintaining adequate organ perfusion/oxygenation during hypotension. A cerebral oxygenation monitor provides clinicians with the values of organ oxygenation. We reported a case that the cerebral oxygenation monitor was used together with HPI to guide intraoperative blood pressure management. We found that cerebral oxygenation was maintained in the event of hypotension during surgery. The patient had no intraoperative or postoperative adverse outcomes despite the hypotension. We believe this can provide an individualized intraoperative blood pressure management to avoid over- or under-treating hypotension.