Angiokeratoma is a rare vascular cutaneous disorder that usually presents as mostly asymptomatic aside from multiple dark red to blue or black papules over the skin in several clinically distinct conditions. Very rarely, it occurs in solitary localized forms that clinically mimic vascular disorders or sometimes melanoma. Solitary cutaneous angiokeratoma may result from damage to a venule's wall in the papillary dermis. This case study describes a 28-year-old male with a single angiokeratoma on the lateral aspect of his upper thigh and a clinical suspicion of a cutaneous melanocytic tumor. This case is intended to raise awareness about such rare skin lesions and the importance of histopathological examination.