This study presents a case of anaphylactic shock in a senile patient, who had a biphasic event associated with the administration of a beta-lactam cephalosporin (ceftriaxone), needing stay in the intensive care unit and support with vasoactive amines, which it is rare to see in this issue, already being in itself a difficult diagnosis and often undervalued by rejecting causes of shock in a senile patient other than cardiogenic or septic. Also, a case review is made based on epidemiological issues, clinical and paraclinical diagnosis, and current treatment implications based on current international guidelines and a review of the topic.