This case involved a fifty-one-year-old male with a twelve year delay in the diagnosis of acromegaly. The patient’s medical history included diabetes, two knee replacement surgeries, and significant dysmorphic facial features. Some of those features included an enlarged tongue, increased teeth spacing, and enlarged skull bones. Additionally, the man experienced chronic headaches unresolved by medication. During fifteen years of established care with his internist, no diagnosis of acromegaly was ever made. The patient was very self-conscious about his appearance and developed depression and anxiety over the last two years. He was especially displeased with difficulties achieving an erection with his wife. His interest in sex had also declined. Most concerning to the patient was that his blood glucose levels remained elevated regardless of good compliance with his diabetes medications. The patient was never referred to a specialist, nor was he ever spoken to about considering other less medically focused options such as sex therapy. One day, the patient developed a severe headache and loss of peripheral vision, which warranted a visit to the local emergency department. The hospital ordered an MRI of his brain, revealing a pituitary adenoma. To confirm the diagnosis, an IGF-1 level was ordered. Subsequently, a diagnosis of acromegaly was made.