We presented a case of a 42 year old male with history of seminomatous testicular cancer, OSA on BiPAP who presented for 10 days of dyspnea on exertion. Prior to this he was healthy up until 2 weeks ago when he complained of fatigue. He also complains of lightheadedness and dizziness that is worsening. On admission he is noted to be pancytopenic and peripheral smear shows abundant spherocytes. After extensive work up he was diagnosed with warm autoimmune hemolytic anemia of unknown origin. His presentation was consistent with Evan’s syndrome which is a rare autoimmune cause of wAIHA. Importantly, these patients tend to develop other autoimmune disorders (SLE), lymphoproliferative disorders or primary immunodeficiencies.