Endocarditis is a serious infection of the innermost muscle layer of the heart and can lead to significant mortality and morbidity. Echocardiography is instrumental to the timely diagnosis of this disease entity. We discuss the case of a patient presenting to the emergency department (ED) with fever of unclear etiology. The diagnosis of right-sided endocarditis was made using focused cardiac ultrasound. A 46-year-old man with a history of intravenous drug abuse presented to the ED complaining of fevers and headaches. Focused cardiac ultrasound demonstrated a tricuspid vegetation. The patient was promptly treated for right-sided endocarditis. This case illustrates the use of focused cardiac ultrasound to facilitate the early diagnosis and management of endocarditis in the ED.