Emphysematous pyelonephritis is lethal infectious disease and its treatment is not established. A 40-year-old woman was cured from the disease with the combination of percutaneous drainage and endotoxin absorption. The patient was admitted to our hospital with high fever and nausea. Computed tomography demonstrated gas accumulation in the right kidney. A day after the admission, she was transferred to ICU because of positive blood culture and renal insufficiency. Serum endotoxin level was 110pg·ml^-1 and her systolic blood pressure was below 70mmHg. She underwent percutaneous drainage and two courses of endotoxin absorption. Her general condition was improving with these therapies and left ICU on the 4th ICU day. We infer that quick institution of percutaneous drainage and endotoxin absorption is the key for treatment of emphysematous pyelonephritis.