Sea urchin belongs to the echinoderm family, with globular or flat, calcified spines covered bodies. There are more than 1000 species of sea-urchins and about 80 poisonous potentially to human. Sea-urchin poisoning symptoms comprise systemic and local effects such as severe pain, syncope, respiratory distress and paralysis. We report a snorkel diver case with near-drowning accident and sea-urchin stung. He was evacuated to our hospital, required mechanical ventilation support and renal replacement therapy due to his rapidly deteriorating conditions, until the sea-urchin spines removal. He had a full recovery and was discharged two weeks after the accident.