Although Taxol® is one of the most successful drugs in current cancer chemotherapy against solid tumors, a major problem is hypersensitivity reactions that arises as a consequence of activation of the complement (C) system, "C activation-related pseudo-allergy". Most severe hypersenstivity reactions occur within the first few minutes of Taxol® administration, usually after the first or second dose. Here we report a case of a severe hypersensitivity reaction in a 72-year-old man undergoing Genexol-PM® infusion. Hypotension and polymorphic pruritic skin rash appeared 2 hours after the start of Genexol-PM® infusion (with an appropriate premedication). Treating with methylprednisolone, epinephrine and inotropic agents, reduced the hypotension and the skin rash disappeared. We report this case with a review of the literature.