Superficial acral fibromyxoma is a very rare benign slow growing myxoid neoplasm identified in recent years. It has a predilection for ungual region of fingers and toes in middle aged adults, presenting as a painless polypoid slow growing nodule or mass involving distal part of finger or toes. It i s a well circumscribed, non-encapsulated dermal neoplasm composed of spindle shaped cells embedded in a myxoid or collageous matrix without significant nuclear pleomorphism. Tumour cells are immunoreactive for CD34 and CD99 and vimentin but variable sensitivity to epithelial membrane antigen (EMA). Treatment consists of wide excision, although malignant transformation has not been documented. Regular follow up is essential as the recurrence rate is reported to be around 24%.