Emphysematous pyelonephritis (EPN) is a bacterial infection characterised by gas production in the renal parenchyma. We present a case with EPN caused by Klebsiella pneumoniae sepsis. The 74-year-old woman was admitted in septic shock. An acute computed tomography revealed gas bubbles bilaterally in the renal parenchyma, left urethra and bladder. Treatment consisted of three types of antibiotics and intravenous fluids. She was discharged two months later without need for surgical treatment or haemodialysis despite the seriousness of her initial condition.