Rituximab is a CD-20 monoclonal antibody used in the treatment of _. Rituximab is a steroid-sparing agent that can be used to control a variety of diseases. (find sources but I found several possible uses). As with any therapy, there are side effects. One potential side effect of Rituximab that has only been described a few times in the literature is hypokalemia. One such report is a case report from 2020 that describes symptomatic hypokalemia in an 18-year-old female with steroid-dependent nephrotic syndrome after her 6th rituximab infusion, with K dropping from 4.0 prior to infusion to 2.3 at the time of symptoms. Did have prior history of dizziness, hypotension and pre-syncopal symptoms after 2 infusions but these were deemed not relevant clinically. The other is a _ conduct by the Saudi Arabia __ that proposes a possibility of rituximab causing hypokalemia, however, does note that these patient’s were also receiving additional chemotherapy agents that These were all in patients with other causes of hypokalemia such as co-administration with another chemotherapy agent or in a patient with underlying nephropathy? Further research should be done potentially on the need for closer monitoring of these patients post transfusion. The purpose of this case is to educate other on the potential electrolyte abnormalities caused by rituximab as these abnormalities can be life threatening. Here we present a case of severe hypokalemia in a patient with underlying Type 1 RTA.