A woman in her 40s with recurrent urticarial-like rash, low-grade fever, fatigue and lower limb pain was diagnosed with Schnitzler syndrome after laboratory results revealed elevated inflammatory markers and monoclonal IgM gammopathy. Histopathology showed neutrophilic infiltrates, and imaging identified osteosclerotic lesions. Her symptoms resolved completely with daily administration of anakinra, an interleukin-1 receptor antagonist.