Refeeding syndrome (RFS), which is often underdiagnosed, is a preventable condition that can be fatal if not managed early. It may occur after nutrition is reintroduced in malnourished patients or those who have experienced a prolonged reduction in food intake. As a result of the metabolic shift from a catabolic to an anabolic state, RFS is characterized by electrolyte disturbances and vitamin deficiencies, which can lead to severe clinical complications. Prevention is the cornerstone of management. This involves monitoring and correcting electrolyte levels in at-risk patients, as well as providing thiamine supplementation before starting refeeding. Nutritional support must be initiated cautiously and progressively.