A 22-year-old female with no known prior co-morbidities presented to us with three days of fever, cough and shortness of breath. She also complained of decreased urine output for one day. She was in shock at presentation which was managed with nor-adrenaline infusion (maximum dose used- 0.3 mcg/kg/min). In view of type 1 respiratory failure with high work of breathing and hemodynamic instability, she was put on mechanical ventilation.  Her RT-PCR test for COVID-19 came positive. Her inotropes were tapered over next 2 days and she was extubated 4 days later. She remained anuric since presentation to us. Her initial work-up for AKI in the COVID-19 ward was non-revealing. A contrast CT scan of kidneys done on day 18 of illness (Fig. 1; A- coronal view; B- axial view) showed reversal of normal cortico-medullary differentiation of the kidneys with enhancing renal medulla (yellow arrows) and bilateral non-enhancing renal cortex (red arrows), popularly called as “reverse rim sign”. A very thin rim of sub-cortical enhancement was present, which is called as “cortical rim sign” (blue arrows). These findings were suggestive of bilateral acute diffuse renal cortical necrosis. Renal cortical necrosis refers to the patchy or diffuse ischemia and destruction of all renal cortical elements due to compromised blood supply. Acute cortical necrosis is a rare cause of acute kidney injury in today’s world outside of obstetric setting. Could vascular occlusion due to COVID-19 might have contributed to the development of renal cortical necrosis in our patient needs to be evaluated. Renal cortical necrosis generally carries poor renal prognosis and recovery if occurs, is often only partial. Our patient remained anuric at the end of 1 month of illness. Acute cortical necrosis should be kept in the list of differential diagnoses in patients with prolonged anuria following COVID-19.