Autosomal dominant polycystic kidney disease (ADPKD) is one of the commonest hereditary disorders. Urinary tract infection is a common complication of this disease. However emphysematous infections in ADPKD have seldom been reported. We report a case of emphysematous polycystic renal infection with Gram negative (Escherichia coli) septicemia in a nondiabetic patient with ADPKD who succumbed to his illness despite aggressive management including early nephrectomy.