Adult-onset Still’s disease (AOSD) is a rare clinical entity without any known etiology that characteristically presents with fever, rash, arthritis, along with other systemic manifestations. We present the case of a 26-year-old male who presented with multiple joint pain, high-grade fever and rash since 2 months. The patient was extensively evaluated for pyrexia of unknown origin and treated with weeks of intravenous antibiotics without any benefit. Applying Yamaguchi’s criteria, he was diagnosed to have AOSD. Patient responded very well to systemic steroids and fever and joint symptoms resolved completely. He required addition of methotrexate as steroid-sparing agent as attempts of tapering prednisolone led to recurrence of symptoms. AOSD remains a very rare but treatable cause of fever and joint pain and high index of suspicion is required for diagnosis.