Star fruit (Averrhoa carambola) is a popular tropical fruit that is usually consumed as fresh fruit or fruit juice. Consumptionof star fruit bypatientswithchronic renal failure can lead toneurologic symptoms. Thepresent report describes the clinical course, management, and outcome of a patient with chronic renal failure admit-ted to an intensive care unit after ingestionof star fruit juice 2 days before hospital admission. Acase of nau-sea, vomiting, intractable hiccups, and severe encephalopathy alongwith mental confusion, disorientation, agitation, andseizures ina53-year-oldwoman ispresented. The patient’s ventilatory pattern worsened, with development of dyspnea and tachypnea, which resulted in her transfer to an intensive care unit. Although hemodialysis was performed and the septic shock was adequately treated, the patient died on the fifth day after hospital admission. The susceptibility of patientswith chronic renal failure to star fruit and the severity of intoxication are poorly known by intensivists. This case demonstrates that star fruit consumption should be considered as a cause of rapiddeterioration in the renal function of patientswithunderlying chronic renal failure, potentially resulting in a fatal outcome.