Hypothermia is relatively a common condition and most cases involve mild hypothermia. But severe hypothermia below $30^{circ}C$ is medical an emergency condition. We report the case of a 41-year-old man who had been left in a manhole for more than 9 hours on a freezing cold water. He was transported to our emergency room in semicomatose state with a body temperature $26.5^{circ}C$. The patient was warmed with active rewarming. After initial stabilization, the patient was taken for a brain computed tomography and found to have large fronto-temporo-parietal[FTP] subdural hemorrhage. The patient underwent an emergent decompressive craniectomy and hematoma evacuation. After surgery, he recovered to drowsy mentation and vital signs were stable.