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Neutropenic enterocolitis is a rare, life-threatening disease, characterized by fever and abdominal pain in the setting of neutropenia. It occurs most commonly in oncologic patients who are profoundly neutropenic as a result of cytotoxic chemotherapy. Neutropenic enterocolitis as a complication of medical therapy for rheumatoid arthritis (RA) has been rarely reported in literature. We describe a patient with RA who developed neutropenic enterocolitis as a complication of methotrexate therapy.