Group A Streptococcus (GAS) is a gram-positive bacterium that can cause infections of varying severity. Invasive GAS (iGAS) is defined as infection involving sterile bodily sites 1 and can be associated with permanent disability and high mortality rate. Children, and particularly Aboriginal and Torres Strait Islander children, are most at-risk from iGAS 1-3 yet there is no vaccine currently available. We present a case of an Indigenous Australian infant who developed iGAS with severe multi-organ dysfunction including cardiac tamponade and toxic shock syndrome.