A case of haemolytic uraemic syndrome following dysentery due to ciprofloxacin-resistant Shigella dysenteriae serotype 1 is reported for the first time. The increasing resistance of S. dysenteriae serotype 1 to many commonly available antimicrobial agents has implications for the management of dysentery. The choice of antimicrobial treatment for S. dysenteriae serotype 1 infections should take into account widespread drug resistance and the risk of haemolytic uraemic syndrome.