Background: Neisseria elongata can behave as an opportunistic infection and can cause an array of diseases, including destructive endocarditis. Around 60% of cases of N. elongata infective endocarditis require surgical intervention. We report a case of N. elongata native aortic valve endocarditis in a previously healthy patient with no known risk factors who required valve replacement. Case Report: A 63-year-old female with no risk factors presented with fevers, headache and anorexia and was found to have Neisseria elongata endocarditis.  Transesophageal echocardiography showed a 1.5×1.5 cm vegetation on aortic valve. Patient did well after aortic valve replacement surgery and a 6-week course of ceftriaxone. Conclusion: N. elongata endocarditis should be thought off in endocarditis cases, even with no apparent risk factors and cardiothoracic surgical evaluation is imperative due to destructive nature of this disease.