Adult-Onset Still’s Disease (AOSD) is an uncommon multisystemic inflammatory disease of no known aetiology.1 Bywaters in 1971 was the first to describe this clinical entity.2,3 Its estimated annual incidence is 0.16 per 100,000 persons.4 AOSD has a bimodal pattern of age distribution with peaks at 15 - 25 and 36 - 46 years. This shows that young adults are mainly affected. 4 It is characterised by daily high spiking fever, evanescent salmon coloured rash, polyarthritis, leucocytosis, and negative immunological study.5 The rarity of the condition has led to a low index of suspicion among clinicians. Four cases of AOSD have been reported so far in Nigeria,6–8 with the first reported in 2015 by Akintayo et al.6 We report the fifth case of AOSD diagnosed at a rural tertiary facility in South-south Nigeria.