A 3-year-old child had severe hemolytic-uremic syndrome with oligoanuric for 31 days and coma for 35 days associated with cortical blindness. She was treated with peritoneal dialysis and supportive care only, and recovered both neurologic and renal function. The spontaneous recovery of this patient who had a particularly severe form of the hemolytic uremic syndrome brings into question the necessity for the use of anticoagulation, antiplatelet agents, prostacyclin, and plasma exchange as treatments for the hemolytic-uremic syndrome.