A 48-yr-old female red-eared slider (Trachemys scripta elegans) presented for a chronically swollen neck and tongue with variable severity of about 6–8 months duration, and tongue swelling for approximately 20 yr. Physical examination revealed an ulcerated, erythematous tongue and an irregular mass in the caudal oropharyngeal region. The hyoid region was markedly enlarged. Initial diagnostics included complete blood count (CBC), plasma chemistry, cytology, and serial computed tomography (CT) scans. The CBC showed signs of basophilia and a regenerative response suggestive of prior anemia. The CT revealed an ill-defined thickening of the tongue base and pulmonary changes consistent with pneumonia. Chelonian herpesvirus PCR was negative. The patient was started on antibiotics and other medications without resolution of signs. Endoscopic evaluation revealed a prolapsed esophagus. A biopsy was taken with subsequent histologic analysis that revealed an ulcerative esophagitis with a fibrovascular polyp. Chronic trauma from the prolapse was the likely cause of these changes. The patient initially did well, but eventually declined and was euthanized after several months.