Thyroid storm is a potentially lethal condition sometimes seen in cases of untreated thyrotoxicosis. Hypermetabolism, fever, and tachycardia are typical symptoms of the increased thyroid hormone activity. Thyroid storm is often triggered by infection, trauma or recent surgery and rarely by other causes. We present a case of thyroid storm and diabetic ketoacidosis (DKA) in a previously healthy male. After extensive lab testing, the patient was found to have both an undiagnosed type 1 diabetes and Graves disease. This combination of underlying conditions and the combined presentation of thyroid storm and DKA pose a significant differential diagnostic challenge, and this case report reminds us to think broadly when presented with an atypical case.