Mycotic aneurysms are a rare finding in the post-antibiotic era but must still be considered as a cause of abdominal pain in a patient with endocarditis. We present a case of a 47-year-old man with a history of IV drug use and a prior episode of endocarditis who developed a mycotic aneurysm while hospitalized on IV antibiotic therapy for aortic valve endocarditis. Due to their life-threatening character and often lack of evident clinical picture, mycotic aneurysms should still remain in high suspicion for a patient with abdominal pain in the setting of endocarditis.