Aim and background: Heavy metal poisoning, including cadmium, can occur with occupational exposure or intake of contaminated food products. The exposed patients may present in the critical care unit with nonspecific symptoms involving multiple organs. The diagnosis may be easily missed in the absence of clinical suspicion, as the presentation may mimic commonly encountered diseases. Case description: We present an unusual case of a 32-year-old woman presenting with a history of intermittent vomiting, loss of appetite, anemia, jaundice, respiratory distress, and decreased urine output. Her sepsis workup, vasculitis profile, antinuclear antibodies (ANA)-18, and investigations for tropical fever were negative. The patient had a tobacco factory at home and was taking weight loss herbal supplements. In view of the clinical history and multiorgan dysfunction of uncertain etiology, heavy metal screening was sent, which revealed high levels of urinary cadmium. The patient was managed in the intensive care unit with supportive treatment, including sustained low-efficiency dialysis (SLED), vasopressors, and mechanical ventilation. However, the patient expired on hospital day 10 due to multiorgan dysfunction. Conclusion: Cadmium toxicity usually occurs with occupational exposure; however, the use of tobacco and ingestion of contaminated food products can be important sources of cadmium exposure. Cadmium toxicity can result in multiorgan dysfunction and shock, which may be difficult to differentiate from other common causes, including sepsis. The management is mainly supportive and involves avoidance of further exposure. Clinical significance: Our case highlights the importance of maintaining a low threshold for suspicion of heavy metal toxicity in patients with unusual presentations and multiorgan dysfunction of uncertain etiology.