Thyroid abscesses are rare complications of neck infections.  We report the case of a teenager who developed increasing neck pain and swelling following treatment for a Streptococcus throat infection.  Imaging demonstrated a complex fluid collection in the left thyroid lobe.  Ultrasound guided aspiration was performed for diagnostic purposes, yielding purulent fluid that grew multiple bacterial species.  Following initial antibiotic treatment, the patient underwent definitive surgical management.  Underlying risk factors and imaging techniques will be reviewed.