A 2-year-10-month-old boy with fever, vomiting, and limb shaking was diagnosed with influenza A-induced acute necrotizing encephalopathy. The condition worsened to a coma with abnormal reflexes. Treatment with tocilizumab (12 mg/kg), antiviral (oseltamivir), and supportive care led to clinical, laboratory, and radiological improvement. Full neurological recovery occurred within 2 months.