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Lemierre's syndrome; a rare cause of septic arthritis. Lemierre's syndrome is a rare condition characterised by pharyngitis leading to septic thrombophlebitis of the internal jugular vein. Complications include pulmonary septic emboli, septic arthritis and disseminated intravascular coagulation. The authors present a case of a healthy woman aged 25 years with septic arthritis of the shoulder due to this unusual cause. This diagnosis was made via a combination of clinical, radiological and microbiological findings. It was successfully treated via surgical and antimicrobial interventions. The patient made a good recovery with minimal associated morbidity or loss of function. This case highlights the importance for awareness and high index of suspicion for rarer causes of septic arthritis in young healthy adults as early appropriate intervention maximises prognosis.