Asparaginase (ASP) is an effective chemotherapy agent extensively used in children with acute lymphocytic leukemia (ALL). There has been a recent interest in using ASP in adults with ALL. We present the case of a 23-year-old patient who presented with fatigue, polyuria, polydipsia associated to a bronchial syndrome and fever with vomiting and abdominal pain. The patient was on chemotherapy for his acute lymphoblastic leukemia (ALL). Blood and urine examination confirmed the diagnosis of diabetic Ketosis. A hypertriglycedemia was also found. The etiology for this both complications was most likely a result of oral glucocorticoid therapy combined with asparaginase therapy. The patient was rehydrated with saline, and antibiotics were administered to treat his infection. He was then slowly brought to euglycemia with sub cutanous insulin injections. Although these complications are relatively rare during the treatment of ALL ( prevalence of 10%), frontline providers should be aware of these side effects because delayed diagnosis may lead to a more severe complications such as ketoacidosis or hyperosmolar hyperglycemia with risk of hypovolemic shock and death