Several unusual infections such as malignant otitis externa, rhinocerebral mucormycosis, emphysematous pyelonephritis and emphysematous cholecystitis exclusively occur in diabetic patients. Each of these diseases is a rare, but potentially life-threatening infection. Therefore, prompt diagnosis and early medical and operative intervention will be necessary for these diseases. We report herein a very rare case in which emphysematous pyelonephritis and emphysematous cholecystitis were simultaneously diagnosed. A 45-year-old man, who was previously diagnosed with secondary diabetes mellitus due to chronic alcoholic pancreatitis ten years earlier, presented with fever and right upper quadrant abdominal pain for 3 days. Abdominal computed tomography showed an air-fluid level in the lumen of the gall bladder and there was gas collection within the right renal parenchyma. Broad-spectrum antibiotics therapy was initiated and cholecystectomy and right nephrectomy were performed. Escherichia coli bacteria were isolated from the culture of the blood, urine and sputum. The patient recovered and was discharged in a healthy state