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A thorn puncture from a rose bush is common, especially in patients who work in outdoor gardening. A healthy 49-year-old man developed Alternariaseptic arthritis with adjacent bone osteomyelitis as a complication of thorn penetration into the radial aspect of the second metacarpophalangeal (MCP) joint. He was successfully treated with joint debridement and irrigation and a prolonged course of itraconazole. In the last 2 decades, fungal infections have become an important cause of morbidity and mortality in humans, especially in immunocompromised patients. We report a healthy 49-year-old man with septic arthritis and osteomyelitis of the second MCP joint caused by the dematiaceous fungus Alternaria. This infection was acquired via thorn penetration into the radial aspect of the second MCP joint while gardening. To our knowledge, this is the first reported case of Alternariaseptic arthritis and osteomyelitis in a healthy man.