Cat scratch disease (CSD) typically presents as regional lymphadenopathy, following inoculation via scratch, bite, or lick to an open wound by a young cat. Annual prevalence is 22,000 cases in the United States. Although CSD is self-limiting in the majority of cases, CSD can manifest in varying presentations and affect multiple organ systems. Serology testing for Bartonella henselae antibodies is a practical diagnostic tool but has limitations. Therefore, it is important for medical providers to recognize CSD in its multiple forms, as antibacterials are indicated in certain presentations. The following cases focus on cardiac and ophthalmic manifestations, as well as delayed seroconversion.