© 2014 Elsevier Inc. All rights reserved. Rhabdomyolysis is due to severe muscle damage from acquired or genetic causes. Myoglobin, a major component of cardiac and skeletal muscle, is released into the blood and is excreted in the kidneys. Excessive levels can lead to myoglobinuria and potentially acute renal failure. The causes of myoglobinuria may be acquired as in crush injury, excess exercise, toxins, infectious diseases, or inherited as metabolic (glycogen or glycolytic disorders) or nonmetabolic (muscular dystrophies) disorders. Diagnosis is required to establish the nature of myoglobin release and therapy is dependent on the cause. Regardless of cause, treatment of acute renal failure is essential as well as management of associated concomitants, such as hyperkalemia or hypo- or hypercalcemia. Mortality may be up to 10%.