Neisseria elongata is a gram-negative rod that resides in the human oropharynx. There are 3 subspecies each of which has been described to cause infective endocarditis. The organism may be difficult to cultivate and identification may require 16S rDNA sequencing. All of the previous cases of N elongata endocarditis have been monomicrobial. This report describes a case of coinfection with Streptococcus sanguis and discusses the management of endocarditis caused by N elongata.