Emphysematous pyelonephritis is a rare but dangerous condition in patients with D.M. and urinary tract infection. We report a case of emphysematous pyelonephritis who presented to us with acute abdomen and sepsis. Her CT abdomen showed air in the collecting system of left kidney. She was managed with, I. V. fluids, antibiotics, insulin, and percutaneous nephrostomy. But she died on the 3rd day of hospitalisation due to Multiorgan failure with sepsis.