Background: Transient bacteremia following tonsillectomy is common but rarely leads to systemic complications. Methods: An immunocompetent adult developed severe systemic complications following a routine diagnostic tonsillectomy. This included multi-joint septic arthritis, bacterial endophthalmitis and infective endocarditis. Results: With aggressive medical and surgical treatment the patient recovered with limited morbidity. Conclusion: Sepsis and its complications are extremely rare following tonsillectomy and this is the first case reported in an adult. A high index of suspicion in the post operative period allows prompt management and limits morbidity.