The purpose of this case study was to provide a retrospective overview of a rare unilateral inferior pubic stress fracture in a competitive runner. A 31-year-old female experienced a deep muscular pain surrounding the adductor insertion following a high intensity sprint workout. An acute adductor strain was suspected upon initial evaluation by a certified athletic trainer. Treatment consisted of ice, electrical stimulation, gentle stretching, low intensity cycling and aqua walking. Symptoms persisted for 2 weeks with a sensation of tightness increasing in the affected hip. Pain continued limiting the ability to bear weight on the affected leg independently. Conservative treatment was continued with the addition of light resistance leg exercises. After 5 weeks of treatment, pain and tightness persisted including minimal gains achieved with range of motion and strength. After consulting an orthopedic physician, x-rays were taken of the hip revealing a unilateral stress fracture of the inferior pubic bone. The athlete’s previous history revealed bouts of anemia, below average body weight, and amennorhea. Due to a family history of low bone density, a dual energy x-ray absorptiometry (DEXA) scan was performed demonstrating borderline osteopenia within the lumbar spine. The athlete was prescribed rest, calcium supplements, and pain-free low intensity cycling. A second x-ray was taken 4 weeks after diagnosis demonstrating a gradual development of a bone bridge over the fracture site. Following thirteen weeks of active rest, she reported minimal pain with walking and while performing daily activities. Sixteen weeks after the initial diagnosis she began walking on a treadmill daily for 10 minutes, gradually increasing the duration of the workout over the next 3 months. While x-rays continued to show gradual healing, a comprehensive lower body strength-training program was initiated. Six months after the onset of symptoms she was able to jog continuously for 45 minutes at a moderate pace without discomfort and returned to a regular strength-training program 3-4 days per week. Symptom-free competitive running began within 8 months of the initial injury. In conclusion, groin and hip pain are common in female runners, however, inferior pubic stress fractures are rare. From this, a thorough patient history and diagnostic imaging is recommended to rule out stress fracture. Allied health professionals and coaches should be aware of injuries such as acute muscular strains, sprains, and inflammatory injuries that may mask possibilities of stress fracture. If misdiagnosed or mismanaged, pelvic stress fractures can run a prolonged and disabling course.