Lemierre syndrome is an acute systemic suppurative infection originating from internal jugular vein septic thrombophlebitis most commonly as sequel to oropharyngeal infection, with Fusobaeterium necrophorum as its most common pathogen. It is prone to misdiagnosis or under-diagnosis due to its lack of specific clinical manifestations, arising from multi-organ involvement. Diagnosis can be established based on positive findings of internal jugular vein septic thrombophlebitis from history collection,physical examination or imaging studies, in combination with evidence of hematogenous infection or metastatic abscesses. Early, sufficient and prolonged course of antimicrobial therapy covering anaerobic bacteria is recommended.