The gram negative bacillus, Ralstonia picketii, is emerging as clinically important nosocomial pathogen. Its particular involvement is seen in immune-compromised patients including end stage kidney disease patients. Contaminated medical solutions, including dialysis RO water, sterile water, as well as disinfectants, can lead to R. picketii outbreak. There have been case reports of invasive infections with variable presentations, also. Very few cases of R. picketii, have been reported from western part of India. We are reporting a case of 36 year old lady, end stage kidney disease patient on maintenance haemodialysis with R. picketii bacteremia. Referred from outside dialysis centre, she presented with complaints of fever and chills during haemodialysis. Blood culture samples from central venous catheter and peripheral blood showed growth of R. picketii. Patient was treated with inj. Ciprofloxacin as per the culture sensitivity report. She improved clinically, with blood culture showing no growth at the end of 14 days of antibiotic treatment.