Sunitinib-associated hematologic adverse events are well known and include leukopenia, neutropenia, thrombocytopenia, anemia, and lymphopenia. Herein, we report the case of a patient with metastatic renal cell carcinoma who was treated with sunitinib and developed severe hemolysis without hypertension or reversible posterior leukoencephalopathy. Prompt discontinuation of the agent resulted in resolution of this complication.