Contact dermatitis from topical corticosteroids is quite common; however, anaphylactoid reactions to systemic corticosteroids are rare. A 50-year-old man suffered from acute cervical spinal cord injury with quadriplegia after a vehicle accident. A total of 500mg methylprednisolone sodium succinate (MPSS) was given intravenously and the patient developed cardiovascular collapse soon after administration. After resuscitation, he became stable. Re-challenge with intravenous injection of 40 mg MPSS induced skin rash without changes of vital signs. We present the rare occurrence of anaphylactoid reaction to MPSS and reviewed the literature.