Recently etanercept, a soluble recombinant tumor necrosis factor receptor:Fc fusion protein, became available to treat patients with rheumatoid arthritis (RA). Among adverse reactions are cutaneous side effects, which occur in about 5% of patients. These have included mostly injection site reactions as well as urticarial reactions. We describe the first case of leukocytoclastic vasculitis associated with the use of etanercept in a patient with severe, deforming RA previously unresponsive to multiple therapies. Discontinuation of the drug led to complete resolution of the vasculitis.