A 67-year-old female was taken to the emergency room for anemia related to rectal carcinoma. Following condensed red blood cell (CRC) transfusion, she had a high fever and petechiae for 11 days. Diarrhea, melena and liver dysfunction were subsequently recognized, and she ultimately died of pancytopenia and multiple organ failure. Regarding the clinical course and HLA typing, a diagnosis of GVHD was made. Her immunological disorder was not particularly severe, and CRC had been made 14 days before. This kind of GVH reaction is very rare, but suggests that we should consider GVHD as a side effect CRC transfusion even in an emergency situation.