Streptococcal toxic shock syndrome (STSS) which is the most severe form of invasive infection caused by group A streptococci has made a global resurgence. To establish the presence of STSS, hypotension and multiorgan failure must accompany evidence of Streptococcal pyogenes infection. We report a case of STSS in a 61 year old diabetic man. The patient presented with septicaemia and septic arthritis of the right knee joint. Group A streptococci were cultured from both blood and pus aspirate from knee joint. The patient had signs of STSS. Early radical drainage debridement plus appropriate antibiotic therapy altered the usual devastating outcome. A wider recognition of the diverse clinical manifestations of group A streptococci is emphasized for early diagnosis, better treatment and possibly improved outcome.