Coccidioidomycosis, commonly known as San Joaquin Valley fever, is a fungal disease caused by Coccidioides immitis or Coccidioides posadasii. When Coccidioides spores are inhaled, they transform into spherules that result in infection. Coccidioidomycosis is also a common cause of community-acquired pneumonia and can cause severe disease in the immunocompromised. Patients may present with fever, chills, cough, chest pain, and shortness of breath. The diagnosis is supported by clinical history, radiology, microscopy, fungal culture, and serological data. Management involves antifungals and supportive care. In severe disease, addressing the etiology of immunosuppression is critical.