: Cholinergic crisis has rarely been reported as a complication of myasthenia gravis, wherein it mainly occurs as a result of the improper accumulation of anticholinesterase agents. In this report, we present one such case. The nature of the patient's clinical manifestations suggested that the main reason for the cholinergic crisis was the abnormal accumulation of pyridostigmine bromide due to renal failure, which was secondary to a tumor in trigeon of bladder. To the best of our knowledge, this is the first report of myasthenia gravis leading to cholinergic crisis caused by acute postrenal renal failure arising from the bladder neoplasm. From our experience in this case, we suggest that renal function and whether the urinary tract is unobstructed should be closely monitored in patients with myasthenia gravis presenting with an acute onset of the signs of cholinergic crisis. In our experience, such cases may be rapidly improved temporarily with continuous renal replacement therapy, but recanalization of the urinary tract and renal function recovery is a fundamental treatment.