ABSTRACT We report a case of fulminant Clostridium perfringens septicemia complicated by massive intravascular hemolysis in a 19‐year‐old male with acute myelogenous leukemia. The patient presented with severe anemia and laboratory evidence of profound hemolysis. Despite the high mortality associated with this condition, the patient was successfully treated with broad‐spectrum antibiotics, including clindamycin, and three consecutive sessions of therapeutic plasma exchange (TPE). TPE was employed to remove circulating α‐toxin and cell‐free hemoglobin, thereby mitigating ongoing hemolysis and organ injury. This case highlights the potential role of TPE, in conjunction with appropriate antimicrobial therapy, as an intervention in C. perfringens septicemia with hemolysis.