Subcutaneous Panniculitis-Like T-cell Lymphoma (SPTCL) is a rare lymphoma with fewer than twenty cases reported in children less than 18 years of age. Trisomy 21 is a chromosomal abnormality associated with a risk of malignancy that differs from their normal counterparts. Leukemia is diagnosed 10-20 times over the general population while solid tumors are underrepresented. The risk for Lymphoma historically has been elevated as well. We describe a case of a 3 year-old girl with Down syndrome who was successfully treated for SPTCL.