We describe a patient who presented with cholera-like diarrhea seven days after eating shellfish at a seafood buffet on the Gulf Coast. The patient's stool culture grew only Vibrio fluvialis on TCBS agar, and his diarrhea and profound acidosis completely resolved within 24 hours of initiating antibiotics. To our knowledge, a detailed case of V fluvialis diarrhea with cholera-like symptoms has not been reported.