Cutaneous manifestations are an important feature of Behçet's disease (BD) and are classified as a major diagnostic criterion by the International Study Group (ISG). Necrotizing vasculitis as a skin manifestation in patients with BD has been reported rarely. In this report, we describe a patient who fulfills ISG criteria for the diagnosis of BD with necrotizing small vessel vasculitis developed necrosis on distal part of the fifth finger of right foot and the heel.