In a case study of acute disseminated encephalomyelitis (ADEM) with haemorrhage, a critically ill 52-year-old male COVID-19 patient was hypoxic on admission, requiring non-invasive ventilation and eventually mechanical intubation. On Day 17 of intensive care, he was slow to wean from sedation, responded only to painful stimuli, exhibited hyper-reflexia with lower limb clonus, and a brain MRI revealed bilateral white matter haemorrhaging. He showed slow improvement with supportive treatment.