Introduction: Transurethral resection of the prostate (TURP) is currently the gold standard for the surgical treatment of benign prostatic hyperplasia. This surgery may lead to TURP syndrome and in some cases, acute tubular necrosis can develop. Case Presentation: We had a 67-year-old male patient who had benign prostate hyperplasia unresponsive to tamsulosin. He underwent TURP surgery. After that, he had acute tubular necrosis because of hemolysis. We performed hemodialysis to decrease serum creatinine level. Discussion: Acute tubular necrosis is the result of hemolysis. Rapid absorption of large volumes of glycerin may lead to hypotension and acute kidney injury. Conclusion: Using distilled water for irrigation during TURP may lead to severe complications like hypotension and acute tubular necrosis.