Background: Anaphylaxis is a life-threatening allergic reaction. Epinephrine is the first-line treatment of this condition. Kounis syndrome indicates the occurrence of acute coronary syndrome in a patient of hypersensitivity, allergy, or anaphylaxis associated with mast cells and platelets activation. Epinephrine can be the etiology of myocardial infarction in this setting. Cases report: This report represents a case of a 58-year-old female who had myocardial infarction while being treated of anaphylaxis in response to cefuroxime intake. Conclusion: Emergency physicians should be aware of the possibility of myocardial infarction in anaphylactic patients to properly manage it.