Infestation with Pediculus capitis, or head lice, is a common occurrence in the pediatric population. These ectoparasites survive by feeding on human blood. While a nuisance, lice are typically considered harmless and the amount of blood imbibed is not usually considered to be of clinical significance. We present a case of a 10-year-old female with severe, prolonged head lice infestation with concomitant iron deficiency anemia that was unable to be attributed to other causes.