Abstract: Hemolytic uremic syndrome is a disease that often requires the transfusion of blood products. A child (two and a half years old, boy) with Shiga toxin-associated hemolytic uremic syndrome who developed respiratory distress after transfusion is presented. The patient was diagnosed with Transfusion-Related Acute Lung Injury (TRALI) after eliminating other possibilities. Transfusions may be complicated by a low rate of potential fatal transfusion-related reactions like TRALI.