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Paracetamol is commonly used to reduce fever in children and is generally considered safe. However, cases of paradoxical hypothermia as an adverse effect are rare. We report a child who experienced significant hypothermia after taking standard-dose oral paracetamol. The child was closely monitored, and no other causes were found. When given lower doses afterwards, the child tolerated the medication without issues. This case emphasises a rare adverse reaction and suggests that conservative management and lower dosing can be effective.