Disseminated gonococcal infection (DGI) is seen in about 0.5-3% of patients with Neisseria gonorrhoeae. Patients with DGI present with mucosal involvement, septic arthritis and sometimes bacteremia. We present a case of a 62-year-old female with a history of HIV and rheumatoid arthritis admitted with DGI and septic arthritis of the wrist without mucosal involvement or systemic symptoms. The patient underwent incision and drainage with arthrotomy of the right wrist by hand surgery and received a 2-week course of intravenous ceftriaxone. After surgery and initiation of antibiotic treatment, there was marked improvement of her symptoms and she remains asymptomatic at follow-up.