Bornholm disease is an uncommon cause of sudden-onset, severe, abdominal pain in adolescents and young adults caused by Coxsackievirus infection. Physicians who care for this patient population should consider Bornholm disease when presented with an acute abdomen or when other serious causes of abdominal pain have been ruled out. Typically, patients with this presentation progress to have pleuritic chest pain associated with a normal chest radiograph. Obtaining Coxsackievirus titers can help confirm the diagnosis. With this case presentation and review of the literature, we demonstrate the varied clinical presentation of Bornholm disease in adolescents and young adults.