Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 61 10 2024 06 08 632 634 Reza Asadzadeh Psychosocial Injuries Research Center, Ilam University of Medical Sciences, Ilam, Iran. Aliashraf Mozafari Psychosocial Injuries Research Center, Ilam University of Medical Sciences, Ilam, Iran. Fakhredin Taghinezhad Department of Nursing, School of Nursing and Midwifery, Ilam University of Medical Sciences, Ilam, Iran Fatemeh Pourrezagholi Chronic Kidney Disease Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Zahra Khalighi Psychosocial Injuries Research Center, Ilam University of Medical Sciences, Ilam, Iran 2022 04 04 2023 12 03 Aluminum Phosphide (ALP) is an effective, cheap, and highly toxic pesticide. ALP poisoning can have destructive effects on the human body, such as the heart, lungs, gastrointestinal tract, kidneys, and central nervous system, although all organs can be involved. We describe a 53-year-old Iranian Kurdish man with Hemolytic Uremic Syndrome (HUS) and Acute Kidney Injury (AKI). Supportive treatments such as hemodialysis and plasmapheresis were performed. After 23 days of hospitalization, the patient fully recovered and was discharged. Thrombotic microangiopathy such as HUS should be considered in patients with ALP toxicity that has a genetic defect in complement proteins. Combined use of hemodialysis and plasmapheresis improve outcomes in these patients. https://acta.tums.ac.ir/index.php/acta/article/view/10077 https://acta.tums.ac.ir/index.php/acta/article/download/10077/5852