We report three preterm infants who were treated with paracetamol for hemodynamically significant patent ductus arteriosus and developed acute hemolysis. No other apparent cause of acute hemolysis was found during Neonatal Intensive Care Unit hospitalization. All three infants were born within 1 year. As this side effect of paracetamol has not been reported previously and many preterm infants receive paracetamol for PDA closure, we advocate awareness. We cannot be sure whether the hemolysis occurred due to an underlying cause that was augmented by paracetamol or whether the drug itself caused acute hemolysis in these preterm infants.