Disseminated intravascular coagulation (DIC) is a life-threatening process in which a systemically dysregulated activation of coagulation and fibrinolysis causes thrombosis and hemorrhage. The systemic activation seen in DIC is commonly secondary to conditions such as: sepsis, malignancy, hemolysis, and trauma but rarely thyroid storm. Thyroid storm is a rare, life-threatening condition characterized by hyperthyroidism, tachycardia, altered mental status, fever, and cardiovascular compromise. We present a case of thyroid storm leading to DIC. A 55-year-old male with a significant past medical history significant for hypertension and hyperlipidemia initially presented to an outside hospital with confusion, hyperpyrexia to 106.6 °F, and hypoxia. In the emergency room he became unresponsive secondary to ventricular tachycardia and required immediate defibrillation with resolution. His initial workup revealed significant acidemia, lactic acidosis, acute kidney injury, elevated troponins, and most significantly a TSH < 0.01 uIU/mL, free T3 of 11.63 pg/mL, and free T4 of 2.72 ng/dL. Upon transfer to our hospital the patient was found to be in multi-system organ failure and rising troponins. His Burch-Wartofsky Point Scale (BWPS) was highly suggestive of thyroid storm given his hyperpyrexia, poor mentation, tachycardia, and hepatic dysfunction. On exam, he was noted to have significant exophthalmos and goiter. Endocrinology immediately started him on hydrocortisone, propylthiouracil, cholestyramine, and oral supersaturated potassium iodide for thyroid storm treatment. Additional labs returned consistent with DIC with markedly low fibrinogen, elevated D-dimer, and thrombocytopenia with active bleeding. He was treated with vasopressors, continuous renal replacement therapy, ventilator support, cryoprecipitate, fresh frozen plasma, platelet transfusions, and broad-spectrum antibiotics. Additionally, the patient developed atrial fibrillation with rapid ventricular response and his hyperpyrexia remained challenging to control despite cooling blankets. Despite the aggressive treatment the patient continued to clinically worsen, his family transitioned to comfort care and the patient passed. This case highlights the course of thyroid storm complicated by DIC. Treatment of DIC is primarily focused on targeted therapy to the underlying etiology, removing the stimulus of coagulopathy. Thyroid storm is suspected when hyperpyrexia, tachycardia, and altered mentation prevail as in this case. The diagnosis of thyroid storm is clinical but may be supported by scoring systems such as the BWPS. Our patient scored over 45 which is highly suggestive of the diagnosis. Patients with thyroid storm require immediate treatment of hyperthyroidism, removal of precipitating factors, and supportive therapy. Patients with thyroid storm have a mortality rate near 25% despite targeted treatments and this significantly increases when complicated by DIC. This case highlights the devastating course of thyroid storm and emphasizes the importance of considering thyroid storm, albeit rare, as an etiology of DIC.