Abstract
Alpha-gal syndrome (AGS) is a delayed-onset food allergy triggered by an immune response to galactose-α-1,3-galactose (alpha-gal), a carbohydrate associated with Lone Star tick bites. A 45-year-old female presented with a 9-month history of nausea and abdominal pain consistently associated with red meat consumption. Initial workup, including routine labs, imaging, and endoscopy, was unremarkable, but specific IgE testing confirmed AGS. Management included strict avoidance of red meat, carrying an epinephrine auto-injector, and referral to an allergist for education and long-term care. This case highlights the diagnostic challenges posed by the delayed reaction and the importance of dietary vigilance and emergency preparedness. Increased awareness of AGS is essential, especially in regions where tick exposure is prevalent.