Fever of unknown origin (FUO) remains a challenging clinical problem despite recent advances in diagnostic tools and techniques. Because primary care physicians are often the first ones to encounter a case of FUO, it is important that they be familiar with the best strategy and steps for confronting this problem intially. Here, Drs Amin and Kauffman review the major causes of FUO in adults and describe an in-depth approach to laboratory and radiologic tests that help establish a diagnosis.