Adult onset Still’s disease (AOSD) is an inflammatory disorder characterized by daily spiking high fevers with an evanescent rash, arthritis,and sore throat.The laboratory features of AOSD include leukocytosis, erythrocyte sedimentation rate (ESR) elevation, hyperferritinemia, anemia, negative tests for antinuclear antibody and rheumatoid factor, and abnormal liver function studies.To establish a diagnosis of AOSD requires the presence of certain major or minor criteria or a combination of both and the absence of certain exclusions such as infection, malignancy, particularly lymphoma and other rheumatic diseases.This case was a 42-year-old man, who presented typically manifesations of AOSD and the laboratory findings met the criteria described as above. After treatment with non-steroidal anti-inflammatory drugs (NSAIDs) and steroids,the spiking fever and other systemic symptoms were alleviated.