Pyoderma gangrenosum is a destructive, ulcerative skin condition often associated with systemic illnesses such as inflammatory bowel disease, myeloproliferative disorders, and the inflammatory arthritides. We present a patient with long-standing pyoderma gangrenosum associated with Crohn's disease. Multiple deep leg ulcerations were unresponsive over the course of several years to treatment with azathioprine, systemic corticosteroids, 6-mercaptopurine, and dapsone. The patient was hospitalized and treated with a ten-day course of intravenous cyclosporine therapy followed by outpatient oral cyclosporine and showed significant improvement.