Local anesthetic systemic toxicity (LAST) is a rare but potentially life-threatening complication of regional anesthesia that affects the central nervous system and cardiovascular system. The article describes the case of a 69-year-old woman with rheumatoid arthritis, admitted for treatment of a fracture of the distal radius, who underwent open reduction and internal fixation. The patient developed CNS symptoms of LAST during regional anesthesia. The authors suggest that rheumatoid arthritis may be a risk factor for LAST due to changes in vascular permeability associated with the disease. Elderly patients with rheumatoid arthritis are at increased risk of LAST. Early diagnosis and administration of intravenous lipid emulsion are key to successful management of the complication. The article emphasizes the need for increased vigilance during regional anesthesia in these patients.