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Abstract This paper reviews the recently concluded successful application of a Managed Pressure Drilling (MPD) system on a High-Pressure High-Temperature (HPHT) well with Narrow Mud Weight Window (NMWW) in the UK sector in the Central North Sea. Well-A was drilled with the Constant Bottom Hole Pressure (CBHP) version of MPD with a mud weight statically underbalanced and dynamically close to formation pore pressure. Whilst drilling the 12-1/2" section of the well with statically under-balanced mud weight, to minimize the overbalance across the open hole, an influx was detected by the MPD system as a result of drilling into a pressure ramp. The MPD system allowed surface back pressure to be applied and the primary barrier of the well re-established, resulting in a minimal influx volume of 0.06 m and the ability to circulate the influx out by keeping the Stand Pipe Pressure (SPP) constant while adjusting Surface Back Pressure (SBP) through the MPD chokes in less than 4 hours with a single circulation. After reaching the 12-1/2" section TD, only ~0.025sg (175 psi) Equivalent Mud Weight (EMW) window was available to displace the well and pull out of hole (POOH) the bottom hole assembly (BHA) therefore, 3 × LCM pills of different concentrations were pumped and squeezed into the formation with SBP to enhance the NMWW to 0.035sg EMW (245 psi) deemed necessary to kill the well and retrieve BHA. MPD allowed efficient cement squeeze operations to be performed in order to cement the fractured/weak zones which sufficiently strengthened the well bore to continue drilling. A series of Dynamic Pore Pressure and Formation Integrity Tests (DPPT and DFIT) were performed to evaluate the formation strength post remedial work and to define the updated MMW. Despite the challenges, the MPD system enabled the delivery of a conventionally un-drillable well to target depth (TD) without any unplanned increase/decrease in mud weight or any costly contingency architecture operations, whilst decreasing the amount of NPT (Non Productive Time) and ILT (Invisible Lost Time) incurred. This paper discusses the planning, design, and execution of MPD operations on the Infill Well-A, the results achieved, and lessons learned that recommend using the technology both as an enabler and performance enhancer.