A 15-year-old female with no significant past medical history who presented with abdominal pain, vomiting, and diarrhea, found to be in acute renal failure and was subsequently diagnosed with multisystem inflammatory syndrome in children (MIS-C). Critical manifestations seen in pediatric COVID-19 can be varied affecting different organ systems. Pediatric providers, during a pandemic with imperfect testing, must be keenly aware of how varied the pathogenesis of COVID-19 can be in children.