We report an unusual case of solitary facial metastasis as first clinical manifestation of an ileal carcinoid. Only one similar case has been reported in the literature. The patient, a 79 years old man, was referred for the excision of a right facial subcutaneous nodule. Pathology showed a soft tissue metastasis of mid-gut carcinoid. After a complete radiological investigation, a small carcinoid of the terminal ileum was found and the patient underwent a right emicolectomy. Pathology confirmed a typical EC cells carcinoid identical to that of the facial tumor. At 2 years of follow-up no clinical or radiological signs of others metastases were found.