Objective: Case report to illustrate that non-healing ulcers should be rigorously investigated to exclude the possibility of malignant neoplasm. Setting: University Hospital, Utrecht, The Netherlands. Patients: One 62-year-old patient presenting with a 3 month history of leg ulcer. Interventions: Diagnostic biopsy followed by radiotherapy and chemotherapy. Results: Histological examination of the biopsy demonstrated a B-cell lymphoma which showed no recurrence during an 8-year follow up-period after treatment. Conclusion: Primary cutaneous lymphoma is a rare cause of malignancy mimicking venous leg ulceration.