IntroductionHyperlactatemia, characterized by elevated levels of lactate in the blood, is commonly associated with various forms of metabolic stress, such as sepsis, shock, and tissue hypoxia. It is generally associated with acidosis. Lactic acidosis is the most common cause of metabolic acidosis in hospitalized patients[1]. Conversely, metabolic alkalosis, a disturbance marked by an increase in blood pH due to excessive bicarbonate or loss of hydrogen ions, often arises from gastrointestinal losses, diuretic use, or renal dysfunction [2] The simultaneous occurrence of hyperlactatemia and metabolic alkalosis is an uncommon and intriguing clinical scenario, as these two metabolic disturbances typically have opposing mechanisms.This case report highlights a rare instance of concurrent hyperlactatemia and metabolic alkalosis, exploring the underlying pathophysiology, diagnostic challenges, and therapeutic approaches. By delving into the clinical presentation, laboratory findings, and treatment outcomes, we aim to enhance the understanding of this unusual combination of metabolic abnormalities and provide insights into their management.