A 28-year-old experienced athlete suffered severe heat stroke after running competitively in hot, humid conditions. He developed disseminated rhabdomyolysis and acute renal failure. His course was complicated by multiple system organ failure and bismuth iodide (BIPP) toxicity. After almost five months in intensive care he recovered sufficiently to be transferred to the ward and subsequently to a rehabilitation hospital and was eventually able to return to work. Heat stroke can be prevented and this case provides several lessons for the running fraternity and the medical profession.