The case of a 71-year-old woman is reported, who neglected a chronic venous ulcer, and presented to the orthopaedic surgeons with a pathological fracture of her tibia due to an invasive squamous cell carcinoma arising from the ulcer. Malignant degeneration of venous ulcers is fortunately rare. However, this case emphasizes the need for regular assessment of long-standing venous ulcers, and illustrates that they may present as an acute emergency to other specialities.