Chronic abuse of furosemide as a cause of hypokalemia has been reported numerous times. However, extreme furosemide-induced hypokalemia is rare and is associated with life-threatening cardiac arrest. Typically, furosemide-induced hypokalemia is characterized by hypocalcemia, hypomagnesemia, high urine calcium/creatinine ratio and high urine sodium excretion. Furosemide-induced hypokalemia may also present with hypercalciuria, nephrocalcinosis and emphysematous pyelonephritis, as evidenced by the case reported herein.