The clinical manifestations of atypical hemolytic uremic syndrome (aHUS) are hemolytic anemia, thrombocytopenia, and acute kidney injury. It is one of the Thrombotic microangiopathy (TMA), with triggers for activation of the complement bypass pathway, such as infection and pregnancy, present in 70-80% of patients. Treatment for this disease requires plasma exchange or eculizumab, we encountered a patient with aHUS induced by gallstone-pancreatitis, after the initial plasma exchange, the patient's condition was improved, but the subsequent incomplete treatment eventually led to severe sequelae. In a word, early, correct and adequate treatment is critical to the prognosis of these patients.