A case is presented of exertional heat stroke in a military setting with numerous complications that have been previously described. In addition, the complication of late rhabdomyolysis with profound elevation of creatine phosphokinase (CPK) is here described for the first time. This rare condition responded to systemic steroids on this occasion. Late elevation of CPK is a rare complication of exertional heat stroke that appears to respond to systemic steroids.