Acute tubular necrosis (ATN) is a syndrome of intrinsic renal injury secondary to ischemic or toxic causes without parenchymal damages and usually non-oliguria. A 20-year old man presented with acute renal failure preceded by 2 days of watery diarrhea. He had been anuria for 48hr with intravenous fluid therapy. Oliguria persisted for 10 days and he required hemodialysis support for 6 days before renal recovery. He denied the use of any regular medication and any intravenous drug use. Renal biopsy revealed severe ATN. Histopathologic findings were marked desquamation of proximal tubular epithelial cells with intact distal tubules and normal glomeruli. We report an unusual case of ATN with anuria and clinically severe features.