Hemophagocytic lymphohistiocytosis (HLH) is a rare but life-threatening hyperinflammatory syndrome that occurs as a primary (familial) or secondary (acquired) disorder. Secondary HLH occurs in response to infection, malignancy, autoimmune disorders, or drugs and presents with fever, cytopenias, elevated inflammatory markers, and hepatosplenomegaly. HScore and HLH-2004 scores, bone marrow biopsy or soluble interleukin-2 receptor (IL-2, CD25) levels are used for diagnosis. Treatment should be started promptly with corticosteroids and other immunosuppressants to reduce morbidity and mortality. In secondary cases, treatment of the underlying cause is necessary, and after resolution of the trigger, long-term immunosuppression against relapses may be necessary. The article describes the case of a patient with severe acute HLH, distributive and cardiogenic shock and multiorgan dysfunction, who was successfully treated with CytoSorb® hemoadsorption therapy. This case highlights the diagnostic challenges, therapeutic interventions, and potential role of hemoadsorption as an adjunctive treatment for HLH.