Background: Cancer related hemolytic uremic syndrome (C-HUS) with Cepacia syndrome is a medical emergency and is a serious complication of metastatic cancer that needs immediate medical intervention. This report is of a woman who is a known case of adenocarcinoma of stomach stage 4 with liver metastasis, and Cepacia syndrome. Case Report: A 61-year-old female patient, known case of stage 4 carcinoma of stomach with liver metastasis who is post second line treatment on palliative chemotherapy presented to the department of oncology with complaints of progressive shortness of breath, weakness, abdominal pain and pedal edema. All the necessary investigations were done. Blood culture and sensitivity report indicated Burkholderia cepacia infection. Complete blood picture revealed presence of schistocytes and toxic neutrophils. Supportive care and symptomatic relief were provided to the patient. Conclusion: This case highlights an atypical presentation of C-HUS with Cepacia syndrome and challenges of managing HUS in immunocompromised cancer patients.