Fulminant hepatic failure is an uncommon but life-threatening adverse reaction to antibiotic therapy. Reported here is a case of severe liver injury associated with ciprofloxacin administered for treatment of a gram-negative infection in a 79-year-old female. The patient presented with metabolic acidosis 48 hours after the first ciprofloxacin intake. Symptoms resolved after cessation of ciprofloxacin therapy. This report highlights an uncommon side effect of a commonly used antimicrobial agent.