Pilomatricomas are uncommon, benign tumors of the hair follicle, which are often misdiagnosed upon initial inspection. Here we describe the case of a 4-year-old boy who presented with a persistent draining tumor on the left side of his neck for approximately two years. The tumor was originally misdiagnosed as scrofuloderma but, eventually, our patient’s pilomatricoma was identified with biopsy and successfully treated with elliptical excision. We discuss the importance of considering pilomatricoma in the differential diagnosis.