We reported a case of hemolytic transfusion reaction producing acute renal failure due to Anti-Jkb in a 35-year-old man with septic hip in post-operative state. At first, he received 7 units of packed red blood cells one month before admission, 2 units for hematuria 7 days before, and with 2 units just one day before the admission. He complained of symptoms and signs accounting for acute hemolytic transfusion reaction with chilling, hematuria, and oliguria. In this case, it seems that the patient acquired unexpected antibody by the episode of transfusion one month ago. He received another transfusion with similar episode of transfusion reaction. His transfusion was repeated and even more severe hemolytic transfusion reaction was presented, leading to acute renal failure.