A patient had a serpiginous lesion on the foot that turned out to be a ganglion cyst. This lesion is more common on the hands. On the lower extremity, ganglion cysts tend to have a misleading clinical appearance. Histologic examination shows pseudocysts formed by mucoid degeneration of collagen structures. The pathogenesis is unclear. Many ganglions are asymptomatic, but pain occurs in 50% of cases. Management of symptomatic lesions is surgical excision. Recurrence is possible.