Gentamicin remains a first line therapy for many severe infections. Its use is associated with a low rate of resistance; moreover, it is inexpensive. Data from medical literature reveal an increase in the incidence of acute renal failure associated with the use of aminoglycosides antibiotics. Presented is a case or a 41-year-old male with a history of liver cirrhosis who developed acute renal failure one week after initiating gentamicin therapy for the management of cellulitis