In foals, Rhodococcus equi infections are typically linked to a range of non-pulmonary conditions, with hemolytic anemia being an uncommon complication. The authors are aware of only one case report involving immune-mediated hemolytic anemia in foals infected with Rhodococcus equi, highlighting the need for further research. This report aims to describe the clinical presentation, progression, outcome, and pathological findings of 4-month-old Holstein foal with Rhodococcus equi infection concurrently with presummed immune-mediated hemolytic anemia. Due to severe sepsis and worsening clinical condition, the foal was euthanized and necropsy was performed.