Background Peritonsillar abscess is a common infection managed by all otolaryngologists. Here, we present a rare case of Neisseria gonorrhoeae induced peritonsillar abscess. Case report A 30-year-old otherwise fit and healthy male presented to a tertiary centre emergency department with a 2-week history of odynophagia, myalgias and fevers not responsive to corticosteroids, penicillin and metronidazole. Examination revealed the classic “hot-potato voice”, trismus and right sided peritonsillar swelling. The patient proceeded to undergo an incision and drainage under local anaesthetic, producing 4ml of pus which was sent for microscopy and culture. The patient was discharged the next day. The microbiology culture was subsequently positive for Neisseria gonorrhoeae, which was treated with a single dose of ceftriaxone and azithromycin. Discussion The peritonsillar abscess is usually polymicrobial in origin, with common organisms including facultative anaerobic bacteria (S. viridans, S pyogenes, S oralis, S aureus) and anaerobic bacteria (Prevotella spp, Peptostreptococcus spp, Clostridium spp). Monomicrobial infections constitute the vast minority of infections. Oral gonococcal infection is an uncommon but well-described aspect of gonorrhoeal infection, usually presenting as pharyngitis. Gonorrhoeal tonsillitis is rarer still, comprising only a fraction of oral gonorrhoeal case reports. To our knowledge, this is the first reported case of peritonsillar abscess secondary to gonorrhoeal infection. Conclusion Neisseria gonorrhoeae is an uncommon but significant cause for oral and oropharyngeal infection, which has broad implications for the patient and their partners. To our knowledge, this is the first reported case of gonorrhoeal peritonsillar abscess.