A 16-year-old girl presented with rectal burning. Results of physical examination were normal except for exudate in the anal canal. Neisseria gonorrhoeae was cultured from the rectal exudate. The urethral, vaginal, and cervical cultures were negative for this organism. Although most patients with anorectal gonorrhea are asymptomatic, some will present with rectal burning, tenesmus, and painful defecation. The diagnosis depends primarily upon an awareness of the condition and its symptoms.