Introduction: Septic jugular thrombosis with secondary osteomyelitis of the clivus due to Fusobacterium necrophorum is a rare complication of Lemierres syndrome. Other complications that can occur include cavernous sinus thrombosis and cerebral arterial vasospasm. Case Report: We present a case of a young girl illustrating the clinical findings of Lemierre's syndrome in addition to other complications that may occur. Retropharyngeal infection with internal jugular venous thrombosis was present in this case along with Fusobacterium necrophorum septicemia. Lemierre's syndrome consists of oropharyngeal infection with internal jugular vein thrombosis, anaerobic septicemia and septic embolization to multiple organ systems. Osteomyelitis of the clivus is a rare, but important complication associated with this syndrome. Fusobacterium necrophorum, the usual pathogen implicated in Lemierre's syndrome has rarely been known to be the sole pathogen implicated in childhood osteomyelitis secondary to septic jugular vein thrombosis. It is important to recognize some of the complications of septic jugular vein thrombosis to reduce morbidity and mortality. Conclusion: Awareness of the clinical and radiologic findings that may be seen in pediatric retropharyngeal infections along with awareness of the possible complications can help guide early treatment or surgical intervention.