We present the case of an adolescent female collegiate distance runner competing in her first 6K race. She presented with multiple systemic symptoms of dizziness, nausea, confusion, muscle cramping, and syncope. The patient was immediately treated for heat stroke and, on follow-up, reported to the AT with a headache, lack of appetite, muscle aches, and dark-colored urine. Rhabdomyolysis should be considered following a heat illness event with necessary treatments performed immediately. Symptomatic patients must be referred to a physician for evaluation and laboratory testing. We present recommendations for a supervised return-to-participation protocol and acclimatization to safely return to competition readiness.