Sonali Rathore, BDS, MS; John Svirsky, DDS, Med; and Bhavik Desai, DMD, PhD; describe a patient presenting with unilateral tongue burning who was previously misdiagnosed with burning mouth syndrome. The final diagnosis was poorly differentiated tonsillar squamous cell carcinoma. This article is peer reviewed and available for 2 hours of CE credit. Learning Objectives: After reading this article, the individual will learn: (1) clinical information on burning mouth syndrome and tonsillar squamous cell carcinoma (SCC), and (2) diagnostic criteria for tonsillar SCC versus burning mouth syndrome.