Intratonsillar abscess is a rare clinical condition in patients who present with odynophagia. We report the case of a 33-year-old man who presented with odynophagia, unilateral tonsillar enlargement with palatal fullness, and deviation of the uvula. Failed attempts at drainage of a presumptive peritonsillar abscess and a worsening of signs and symptoms led to a clinical suspicion of a parapharyngeal abscess. Computed tomography of the neck detected a 2.6 x 2.3-cm intratonsillar abscess. The abscess was drained, and the patient's signs and symptoms resolved. Our review of the current English-language literature revealed that only 8 such cases have been previously reported. We report this new case to increase awareness of this condition, to demonstrate the diagnostic difficulty in such cases, and to discuss the pathophysiology of intratonsillar abscess formation.