Aerococcus urinae (A. urinae) is an infrequent cause of infective endocarditis (IE) and few cases have been reported especially in older women. As of this publication, there are 31 reported cases of IE caused by aerococcus urinae, and of these, 4 are of women, 3 of which are aged > 75 years. Here, we describe a case of A. urinae endocarditis in an 80-year-old woman presenting with worsening fatigue. A diagnosis of native aortic valve endocarditis was established based on characteristic findings of aortic valvular vegetation on transesophageal echocardiogram along with isolation of A. urinae on blood cultures.