Objectives: The purpose of this case report is to describe the presentation, otolaryngologic manifestations, diagnosis, and management of scurvy, a disease process rarely seen in modern industrialized nations. Methods: Case report Results: A 77-year-old Greek woman with a 4-month history of recurrent epistaxis, ecchymosis, and chronic hyperpigmentation, presented to the Otolaryngology Department for biopsy of numerous tender intermittently bleeding gingival lesions. At presentation, she was undergoing an evaluation for anemia and rectal bleeding. Her medical history was remarkable for Graves’ disease treated with thyroidectomy, osteoporosis, chronic anemia, and multiple food sensitivities associated with pruritis, hives, and petechiae. Her diet for 2 years consisted of only red meat, bread, and olive oil. Examination revealed diffuse hyperpigmentation, purpura of the extremities, hypertrophic gingiva with multiple firm, tender, exophytic lesions. Significant results of her comprehensive work-up yielded an undetectable level of serum vitamin C, a skin biopsy with evidence of hemorrhage and hemosiderosis, and an alveolar biopsy revealing an inflamed angiomatous lesion consistent with pyogenic granuloma. Treatment with 100 mg of oral vitamin C 3 times daily resulted in complete resolution of her hyperpigmentation and gingival lesions after 6 days and improved blood vitamin C levels. Conclusion: The otolaryngologic manifestations of scurvy have not been reported in the otolaryngology literature and have been infrequently reported over the last 20–30 years. Through discussion of the complex presentation, disease manifestations, and treatment, this case report revisits a rare disease and emphasizes the need to include scurvy in the differential diagnosis of gingival and oral cavity lesions.