Nephrotic syndrome (NS) may have complications like infection, thromboembolism, acute kidney injury (AKI) and hypovolemia in children. However, severe AKI with anuria is unusual and rarely reported. In this study, 9 year-old girl hospitalized with f irst episode of NS after recent antibiotic and ibuprofen use was presented. Despite albumin and furosemide, as she became anuric on the third day of hospitaliza- tion, hemodialysis was started and pulse methylprednizolone was given. Renal biopsy revealed minimal mesangial proliferation with widespread acute tubular injury findings. She was discharged at the 15th day with normal urine volume after 11 hemodialysis sessions. Afte r six weeks of oral prednisolone, complete remission in NS was achieved. Acute tubular necrosis was the underlying diagnosis for anuric AKI in the setting of NS. Heavy proteinuria leading to tubular obstruction, presence of decreased effective intravascular volume due to severe hypoalbuminemia, and ibuprofen use may have caused acute tubular necrosis.