Ethylene glycol (EG) is a common constituent of anti-freeze, coolants and other solvents and is responsible for both inadvertent and intentional poisoning.1 Ethylene glycol poisoning may pose diagnostic difficulties if the history of ingestion is not volunteered, or if the presentation is delayed. The toxicity is because of biochemical features of high anion gap metabolic acidosis and an osmolar gap. It usually resolves within 24–72 h as the ethylene glycol is metabolized to toxic metabolites. We are reporting a case which had rapid progression of symptoms and also encountered low arterial pH despite giving I/V sodium bicarbonate.