Mycoplasma pneumoniae-induced rash and mucositis (MIRM) is a disease characterized by mucosal involvement with variable cutaneous manifestations induced by M. pneumoniae infection. Previously reported rash morphologies include vesiculobullous, targetoid, papular, macular, and morbilliform lesions. Pustulosis is a rare presentation of MIRM that has been described only once before in the literature to our knowledge. We report a case of a 13-year-old boy presenting with a pustular skin eruption induced by Mycoplasma infection. Ours' is the second report of MIRM, to our knowledge, presenting with pustulosis and the first, to our knowledge, to first to describe the histopathologic finding of perifollicular neutrophilic infiltration in MIRM.