Plasma cell leukemia is one of the most aggressive and rarest forms of plasma cell dyscrasias. It can arise from a leukemic transformation of multiple myeloma or can be primary and the prognosis is very poor. We present the case of a 68 year old male who presented to our hospital with features of acute renal failure. He was diagnosed as a case of Plasma cell leukemia and was treated with chemotherapy. However his condition deteriorated and he died 2 weeks after diagnosis. The recommended treatment of plasma cell leukemia is aggressive chemotherapy followed by stem cell transplantation. However, once diagnosed, the prognosis is very poor.