Bleomycin is an effective drug used in the therapy of many malignant diseases. Such toxicities as fever, chills, and pulmonary fibrosis are well known to occur following administration of this drug. A rare fatal hyperpyrexial response has also been noted with this agent. We describe a case of fatal hyperthermia after an injection of bleomycin. Unlike earlier reported cases, our patient developed her reaction following prior uneventful therapy with bleomycin rather than as a response to initial treatment. Factors that may be related to the hyperpyrexial response to bleomycin are discussed and the relevant literature reviewed.