Bacterial coinfection and COVID-19 have been reported in pediatric populations. We describe a case of Sydenham's chorea, which is exceedingly rare in developed countries, with concurrent COVID-19. Discussed here is the clinical course of an 8-year-old COVID-positive female with pure Sydenham's chorea and subclinical carditis from acute rheumatic fever. To our knowledge, there are no documented reports of acute rheumatic fever in a pediatric patient with coexisting COVID-19 infection.