Introduction: Mycoplasma-induced rash and mucositis (MIRM) is a newly recognizedmucocutaneous condition associated with Mycoplasma pneumoniae infection and often misdiagnosed as Stevens–Johnson Syndrome (SJS). MIRM is characterized by prominent mucositis with minimal skin involvement, typically following a respiratory illness. Early recognition and multidisciplinary care are essential to prevent complications, particularly ocular sequelae. We report a case of severe MIRM in a school-aged child requiring intensive supportive therapy . Case presentation: An 11-year-old previously healthy girl presented with a week of cough andrhinorrhoea, followed by painful oral ulcers, lip crusting, fever, and bilateral conjunctivitis. A few scattered papular skin lesions were noted, with otherwise normal systemic examination. Respiratory PCR confirmed Mycoplasma pneumoniae, while viral and bacterial investigationswere negative. A diagnosis of MIRM was established. She required ICU admission for sedation, airway protection, enteral feeding, and intensive pain control. Multidisciplinary involvement included ophthalmology for topical steroids, lubricants, and prophylactic antibiotics, and dermatology for oral corticosteroids and skin care. Azithromycin was administered, and shewas discharged after 16 days with improving mucosal lesions and a steroid taper. Conclusions: This case highlights the importance of distinguishing MIRM from SJS to guide timely , supportive, and organpreserving care. Increased awareness of this entity among paediatric clinicians may reduce diagnostic delays and improve outcomes.