Erythema nodosum is an uncommon skin eruption frequently associated with underlying infections, systemic diseases, or drug toxicity. We report the case of a 27-year-old aviator with three occurrences of erythema nodosum attributed to streptococcal pharyngitis. We review the causes of erythema nodosum to emphasize the importance of a thorough investigation to rule out serious underlying disease prior to returning an aviator to flight status.