Persistent hiccups in the perioperative setting, although uncommon, can substantially impact a patient's wellbeing and recovery after surgery. We present a case of a 51-year-old male who developed persistent hiccups during total knee replacement surgery under neuraxial anaesthesia. The hiccups persisted postoperatively, leading to multidisciplinary interventions, including the introduction of central-acting muscle relaxant, baclofen. This case highlights the complexity of managing persistent hiccups in the perioperative period, where both aetiology and treatment are multifactorial, emphasising the need for further research in this field.