Although rare, influenza A-associated rhabdomyolysis can rapidly progress to multiorgan failure. A previously healthy 22-year-old man returned to the emergency department eight hours after his initial visit with dark urine and rapidly deteriorating clinical status. Influenza A was detected. Creatine kinase peaked at 320,050 U/L, accompanied by severe hyperkalemia, profound mixed acidosis, hypercapnic respiratory failure, hypotension, and anuric acute kidney injury. The patient required invasive mechanical ventilation, vasopressor support, urgent intermittent hemodialysis, and continuous renal replacement therapy. Diuresis resumed during the first week, continuous therapy was discontinued on hospital day 9, and the final hemodialysis session was performed on day 19. The patient recovered without requiring long-term dialysis. Dark urine or disproportionate enzyme elevation during influenza infection should prompt immediate creatine kinase testing and serial monitoring of electrolytes, acid-base status, renal function, and urine output. Timely organ support may enable recovery despite extensive muscle injury.