Crohn's disease is a chronic inflammatory disease that can affect any part of the gastrointestinal tract. Classically the disease has a predilection for the distal small bowel and colon and presents with dominant symptoms of abdominal pain and diarrhea. This case report describes a 38-year-old woman with Crohn's disease who presented with odynophagia. Direct visualization of the oropharynx revealed a large serpiginous Crohn's disease ulcer. A precipitous drop in hemoglobin prompted a series of gastroenterologic investigations that confirmed both ileal and oropharyngeal Crohn's disease. This manuscript describes the presentation of oropharyngeal Crohn's and reviews previous reports and management options.