Thyroid storm is a rare endocrine emergency that rarely presents with septic shock. It occurs inthyrotoxic patients and is manifested by decompensation of multiple organs, triggered by severestress. The diagnosis and response to treatment is made by Burch-Wartofsky point scale or Japanesethyroid association criteria due to lack of pathophysiology of thyroid storm. We reported series ofpatients that presented with altered sensorium, cough, fever, palpitation, shortness of breath andshock. Patient were treated initially for septic shock, later diagnosed as thyroid storm and was treatedwith oral carbimazole, propanolol and digoxin. From this, we want to emphasize that thyroid stormcan have any presentation that should be kept in differential diagnosis of septic shock not respondingto usual treatment; early diagnosis and treatment with oral medication can decrease morbidity andmortality in rural setting where intravenous form of antithyroid drug are not available for thyroidstorm.