Lemierre syndrome also called postanginal septicemia or human necrobacillosis, begins as pharyngitis, usually due to Fusobacterium necrophorum but is characterized by acute septicemia and findings consistent with ipsilateral jugular vein thrombosis. Clinically, there may be pain, edema, and tenderness in the anterior cervical triangle. Septic emboli to the lung may lead to pulmonary abscesses and empyema. In this case report, we describe a patient with atypical presentation of Lemierre syndrome, with sparing of the ipsilateral internal jugular vein with septic thrombophlebitis of the contralateral one. On review of medical literature, this is the first case of Lemierre disease with contralateral internal jugular vein thrombosis.