Acetaminophen is the most prevalent, deliberately ingested medication in overdose episodes and a key cause of acute liver failure. N-Acetylcysteine (NAC) is used to treat an overdose of acetaminophen. Using NAC may cause rare fatal adverse events which could affect the safety of the patient. Generally, the type and frequency of NAC related events are too minimal to be considered as an adverse reaction. It is necessary to examine the route of administration, method of reaction detection and the nature of the reactions. These events does not preclude patients from receiving this hepatoprotective advantage, particularly in the context of significant acetaminophen ingestion. We present our case and highlight the clinical inference which can be derived from this entity.