Abstract: Arthritis may be the first clinical manifestation of primary hypogammaglobulinaemia. We report a case of primary hypogammaglobulinemia who presented with migratory polyarthritis and sore throat. The diagnosis of primary hypogammaglobulinemia (Brutons disease) was delayed as it was previously thought it was migratory polyarthritis, due to Rhematic fever, Which is very common in Asian countries. These patients are likely to develop recurrent infections complicated by arthritis. This delay resulted in considerable joint destruction. The measurement of serum immunoglobulin concentrations readily differentiates immunodeficiency from conditions such as Stili's disease and dictates subsequent management. The importance of presenting this case was that one should be in look out for something more in cases where child is not responding well to antibiotics and getting various bacterial infections on and off