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Essential thrombocytosis (ET) is a rare disease with known thrombotic and bleeding complications. We encountered a patient with a diagnosis of longstanding Janus kinase-2 gene–negative ET on aspirin therapy presenting for labor epidural. Evaluation of platelet function with point-of-care analysis using Plateletworks in a community hospital setting allowed confirmation of adequate numbers of functional platelets to support safe epidural placement. The relevant issues of ET for anesthesia management with labor epidurals are discussed. Unique, relevant, and unexpected findings from the platelet function testing are presented.