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Background: McKittrick–Wheelock syndrome is an uncommon and severe disorder caused by large hypersecretory tumors located in the distal colorectal area. Excessive secretion from adenomas is an unusual clinical manifestation that leads to severe electrolyte and fluid depletion, subsequently resulting in kidney injury. Successful treatment relies on quick and cooperative decision-making for timely intervention. Case presentation: A 79-year-old Bulgarian male patient was admitted to the emergency department with syncope resulting from severe electrolyte depletion and renal failure caused by excessive secretion from a rectal polyp. The initial diagnostic and treatment journey included computed tomography, rectoscopy, biopsy, and an attempt at piecemeal removal, ultimately leading to abdominoperineal resection. Despite the permanent colostomy, the patient experienced a smooth recovery and significant improvement in his quality of life. Conclusion: McKittrick–Wheelock syndrome begins with nonspecific initial symptoms in the first extended latent phase, mainly diarrhea, followed by a brief deterioration phase and decompensation phase. However, the key to restoring renal function and correcting electrolyte imbalances lies in surgically removing the tumor, making early detection crucial. Employing a multidisciplinary strategy that includes prompt recognition, timely intervention, and thorough preoperative stabilization is crucial for achieving successful outcomes. [ABSTRACT FROM AUTHOR]