摘要Rationale: Pituitary apoplexy (PA) is a rare endocrine emergency that requires prompt diagnosis and management. Dengue fever-induced-thrombocytopenia may rarely predispose to PA. Patient's Concern: A 58-year-old male patient having known pituitary macroadenoma presented to the emergency department with fever, a sudden onset severe headache, and altered sensorium. Diagnosis: Pituitary apoplexy caused by dengue fever-induced-thrombocytopenia. Interventions: Conservative management with fluids, mannitol, dexamethasone and symptomatic treatment. Outcomes: The patient responded well to the treatment and was discharged uneventfully. Lessons: Although dengue hemorrhagic fever is a rare cause of pituitary apoplexy, it should be considered if a patient presents with headache and altered sensorium, and prompt initiation of treatment is crucial to prevent fatality and neuro-ophthalmic deficits.