Presenting a case of acute theophylline and salbutamol overdose with distributive shock. A 21-year-old lady presented with history of consumption of 3 g of theophylline and 40 mg of salbutamol. On admission, she had altered sensorium with a systolic blood pressure of 60 mmHg, unrecordable diastolic blood pressure, and heart rate of 147/min. Investigations revealed severe metabolic acidosis, hypokalemia, and hypocalcemia which was managed by intravenous fluids, vasopressors, infusion of calcium gluconate and potassium chloride. As her hemodynamic status did not improve, she was initiated on 1.5 mL/kg lipid emulsion as bolus and 0.5 mL/kg/h as infusion. Her hemodynamic status improved gradually and she was discharged in 24 h. Timely administration of lipid emulsion resulted in early recovery of shock. © 2021 Elsevier B.V., All rights reserved.