Background: Fever is a common complaint among children with an underlying oncologic diagnosis, especially during chemotherapy courses and periods of neutropenia. Chemotherapy-induced fever is well described in relation to specific chemotherapy agents. However, fever induced by vincristine (VCR) has only been rarely reported. Case: We describe a case of a 5-year-old female with stage III Wilms tumor who had recurrent VCR-associated fever that was controlled with prophylactic dexamethasone and acetaminophen. Conclusion: In patients developing recurrent fever following chemotherapy with VCR, febrile allergic reaction and prophylactic treatment should be considered after exhaustion of appropriate investigations.