Abstract: Objective To summarize the experience in diagnosis and treatment of disulfiram-like reaction. Methods The diagnosis and treatment of a small amount of beer drinking induced disulfiram-like reaction in a pilot during intravenous drip of cephalosporins were retrospectively anlyzed. The patient was a male helicopter pilot aged 31 years. After ureteroscopic holmium laser lithotripsy, he was treated with cephalosporins (1.0 g, twice a day). He complained of dizzy, chest distress, sleepiness, and drunkenness 1 hour after he drank a bottle of beer at supper. His blood pressure was 80/30 mmHg (1 mmHg=0.133 kPa) and his heart rate was 110 beats/min. Results He was diagnosed as disulfiram-like reaction according to his history of drug use and a small amount of alcohol drinking, symptoms, signs and ECG. After treated with parental fluid, oxygen inhalation and glucocorticoid, his symptoms disappeared. Conclusion A small amount of alcohol drinking can immediately induce disulfiram-like reaction in pilots during intravenous drip of cephalosporins.