The Presidency plays a central role in the functioning of the Czech political system. Among others, the President convenes the first sitting of the Chamber of Deputies after elections and must appoint the Government before it can seek parliamentary confidence. Therefore, the emergency hospitalization of President Miloš Zeman after the 2021 parliamentary election presented politicians with a hitherto unprecedented dilemma. Although a full-scale constitutional crisis was eventually averted, the incident still demonstrated the ambiguity and limitations of constitutional provisions on presidential inability and the temporary transfer of presidential powers in the Czech Republic. This article discusses the respective constitutional provisions and assesses their expedience in light of recent events. Drawing on historical precedents and political debates from the last 30 years, the article proposes options for reform and argues that constitutional crises will remain a real possibility unless political actors agree on at least a minimum of procedural requirements.