Tumor lysis syndrome (TLS) is an oncologic emergency that occurs due to the massive lysis of tumor cells resulting in hyperkalemia, hyperuricemia, hyperphosphatemia, and hypocalcemia. Patients are at significant risk for acute kidney injury, arrhythmia, seizures, and sudden death as sequelae of this condition. Management is dependent on severity but often includes acute stabilization, aggressive hydration, correction of electrolyte abnormalities, and uric acid-lowering medications, such as rasburicase and allopurinol. TLS carries high morbidity and mortality risk making prevention through intravenous hydration and prophylactic medications the best management strategy.