Introduction  
Tetanus is a now rare disease due to the widespread administration of scheduled and prophylactic vaccines, making it exceptionally uncommon to appear in many emergency departments.  Clinical suspicion alone is used to make the diagnosis as there are currently no immediate diagnostic tests available to the clinician.  If left unrecognized and untreated, however, tetanus can lead to airway compromise and death.   
Case Report 
We report a case of a young male who presented to the emergency department with intermittent full body spasms and lockjaw in the setting of recent assaults and lacerations weeks prior who had not received tetanus since 2008.  Immediate calls were placed to infectious disease consultants and the patient was treated with intravenous immunoglobulin, tetanus immunization, metronidazole, and ceftriaxone.  Further work up revealed rhabdomyolysis, elevated lactate, and unremarkable imaging. 
Conclusion  
His symptoms improved to resolution with completion of his therapy, effectively confirming the diagnosis of tetanus.