A 35-year-old laborer suffered classic heatstroke after 5 hours of exertion in high temperatures and was admitted in a coma with a GCS of 3. Standard treatment included active cooling, mechanical ventilation, and supportive therapy, but the patient remained unconscious with quadriparesis. CT and MRI showed abnormalities in the cerebellar hemispheres and basal ganglia, consistent with heat stroke encephalopathy. After stabilization of body temperature, he started hyperbaric oxygen therapy at 0.20 MPa for 60–80 minutes per day in 10-day cycles. After 27 sessions, there was an improvement in consciousness, limb strength, assisted walking and partial return of speech. The patient was discharged in accordance with medical advice. HBOT was associated with neurological recovery after partial improvement. The exact role of HBOT alongside supportive care remains uncertain.