Ankylosing spondylitis (AS) a seronegative inflammatory disease that often presents with co-existing issues like bilateral hip replacements, nephrolithiasis, skin lesions, peripheral vascular disease and coronary artery disease.. We describe a patient with ankylosing spondylitis with bilateral hip replacements in the past who was waiting for an elective coronary artery bypass grafting (CABG) but needed urgent admission with renal colic and unstable angina. In the current COVID pandemic in order to reduce hospital stay and risk of hospital acquired COVID infection we decided to perform simultaneous CABG and removal of ureteric stone. In this case report we discuss the issues in relation to management of patients with coronary artery disease and ankylosing spondylitis.