Esmolol chloride was commonly used in anesthetic induction to blunt cardiovascular responses of tracheal intubation. Because of its short half-life, esmolol was considered as a relative safe agent in anesthetic practice. Here, we present a 49-year-old diabetic female patient scheduled for vitrectomy. She suffered from a cardiovascular collapse after general anesthetic induction combined with esmolol. The bradycardia and shock cannot be corrected with repeated doses of adrenergic agents including epinephrine. Cardiopulmonary resuscitation persisted for forty minutes to regain the vital sign. The followed examinations didn't reveal definite pathology such as acute myocardial infarction or anaphylaxis. In this report, we discussed the possible causes of shock and reviewed the esmolol-related cardiovascular collapse and its treatment.