We report the case of a 48-year-old American traveler who presented to our clinic with diffuse rash, malaise, fatigue, fever,arthralgia, low back pain, and bilateral exudative conjunctivitis. The patient had an extensive vaccination and travel history: mostnotable for prior receipt of yellow fever vaccine; extensive travel or residence in areas endemic for dengue, chikungunya, and WestNile virus; and recent travel to French Polynesia. Clinical and laboratory ndings were consistent with Zika virus (ZIKV) infection.Our report highlights the need to include ZIKV in the differential diagnosis, especially in febrile patients with a rash returningfrom endemic areas.