A patient who had toxic shock syndrome (TSS) after intraoral surgery is described. A 54-year-old woman had pyrexia (40°C), nausea, vomiting, watery diarrhea, and muscle soreness 7 days after surgery for carcinoma of the oral floor. An infection due to methicillin-resistant Staphylococcus aureus (MRSA) developed at the oral wound and progressed rapidly to fulminant septic shock with erythroderma, severe hypotension, and multiple organ dysfunction. The patient received infusion and transfusion therapy, respiratory care, antibiotics, continuous hemodiafiltration, and local irrigation, resulting in a good prognosis. Microbiological examinations revealed that toxic shock syndrome toxin-1 (TSST- 1) was positive in the oral MRSA on the 19th postoperative day. TSS should be considered as a potential complication of oral and maxillofacial surgery.