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This case report describes a patient with advanced gallbladder cancer who developed septic shock associated with iodine-125 (125I) seed implantation. The treatment process is described to provide a clinical reference for similar cases. A 52-year-old woman with recurrence of advanced gallbladder cancer underwent 125I seed implantation and developed postoperative sepsis with septic shock. The blood culture suggested infection with Aeromonas caviae and Enterococcus faecalis. Vancomycin and imipenem were immediately administered according to the drug sensitivity results, along with immunoglobulin therapy and vasoactive drugs. The patient's condition gradually stabilized after comprehensive treatment. Sepsis with septic shock is a rare but potentially fatal complication of 125I seed implantation. Timely administration of broad-spectrum antibiotics, immunoglobulin therapy, and vasoactive drugs is very important to stabilize the patient's condition. Our treatment of this patient can serve as a reference for clinicians to manage this complication in similar cases.