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Cardiomyopathy secondary to severe vitamin D deficiency is an under-recognised cause of heart failure in the paediatric population. There is growing evidence to show that vitamin D plays a crucial role in maintaining normal cardiac function due to the vitamin D receptors found on cardiac myocytes and calcitriol-dependent Ca2+-binding protein. This article presents the case of an infant who presented to a district general hospital paediatric emergency department in cardiogenic shock and was later diagnosed with severe vitamin D deficiency-associated cardiomyopathy.