Introduction:Felty syndrome, also known as Chauffard-Still-Felty syndrome, was first described by Augustus Felty. It is a rare condition diagnosed in patients with longstanding seropositive rheumatoid arthritis (RA) characterized by an enlarged spleen and neutropenia (1). Neutropenia, defined as absolute neutrophil count <1500/mm, is Felty syndrome’s hallmark feature. In RA, the patient usually presents initially with arthritis, and the felty syndrome commonly develops after many years. However, in highly uncommon instances, felty syndrome can manifest before or without any signs of arthritis. Only a few case reports have been published highlighting this unusual presentation of the Felty syndrome (Table 2). We present a similar case of a young female who initially presented with felty syndrome without arthritis. This case report emphasizes the clinical and diagnostic approach to rule out alternate causes of neutropenia with splenomegaly and timely recognition of the atypical presentation of Felty syndrome.