Abstract: Lemierre syndrome is an anaerobic suppurative thrombophlebitis of internal jugular vein (IJV) occurring after head and neck infections. Septic emboli to lungs, systemic sepsis, and metastatic abscesses can occur. In preantibiotic era, it was common and fulminant, with a mortality of 90%. The most common pathogen is Fusobacterium necrophorum. Here, we present a case of Lemierre syndrome presenting with atypical symptoms, mainly involving the gastrointestinal system. Positive blood cultures for F necrophorum led to radiologic testing, which revealed thrombus in the IJV. This case highlights the importance of early radiologic testing for thrombus in IJV; otherwise, the diagnosis of Lemierre syndrome may be missed, which, in the absence of early and appropriate antibiotic treatment, may be rapidly fatal.