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Abstract We present the case of a 60-year-old diabetic who had acute-onset shortness of breath that was preceded by bilateral thigh and hip pain. He was initially admitted for septic arthritis with community-acquired pneumonia. His respiratory complaints resolved, but he continued to have thigh pain. Ultrasound of the lower limbs showed thrombosis of the deep veins of the thigh and MRI showed a collection in the right thigh suggestive of pyomyositis with thrombosis in deep veins abutting the collection. Contrast enhanced CT (CECT) chest showed multiple peripherally located pneumatoceles and cavities in both the lungs suggestive of septic emboli. Here, we present a case of pyomyositis of thigh muscles causing Deep vein thrombosis (DVT) and septic pulmonary emboli (reverse Lemierre’s syndrome).