Rationale <p>Iodophor, a disinfectant composed of iodine complexed with a surfactant, is extensively employed for preoperative skin preparation, burn wound management, and mucosal disinfection. Despite its extensive application in clinical practice, emerging clinical evidence has documented associations between iodophor irrigation and acute kidney injury in human. However, systemic iodine toxicity after the seminal vesicle was irrigated with iodophor during transurethral seminal vesiculoscopy (TUSV) has not been previously described.</p> Patient concerns <p>We report the case of a 70-year-old man who developed transient hypotension, vomiting, confusion, and profound lactic acidosis after the seminal vesicles were irrigated with iodophor.</p> Diagnoses <p>The patient was diagnosed with confusion and profound lactic acidosis secondary to the seminal vesicle was irrigated with iodophor.</p> Interventions <p>The patient was admitted to the intensive care unit (ICU), and continuous venovenous haemodiafiltration (CVVH) was initiated 3&#xa0;h after ICU admission.</p> Outcomes <p>After six days, the patient’s condition improved, allowing the cessation of CVVH. He was discharged from the hospital on the 22nd day after being transferred to the ICU.</p> Conclusion <p>This case highlights the typical characteristics of iodophor absorption during its regular application. Here, we report the first case of systemic iodine toxicity caused by iodophor irrigation during transurethral seminal vesiculoscopy.</p>