Tetanus is an increasingly rare diagnosis in the post-vaccination era, although it continues to have significant morbidity and mortality worldwide. In the United States (U.S.), the incidence of tetanus has declined dramatically due to the widespread use of the vaccine. High-risk populations for tetanus in the U.S. include the elderly, diabetics, injection drug users, and unvaccinated individuals. This is a report of a 78-year-old male with an incomplete immunization history who presented to an emergency department with jaw pain and who was ultimately diagnosed with tetanus. This report highlights the importance of prompt diagnosis, treatment, and prevention of tetanus.