Cowpox in humans is a rare zoonotic disease; its recognition is therefore problematic due to the lack of clinical experience. The differential diagnosis includes other poxvirus infections and also infections with herpesviruses or selected bacteria. The clinical course can be complicated and the improvement may take weeks. Late diagnosis is one of the causes of unnecessary combined antibiotic therapy or surgical intervention. A case of cowpox after a cat scratch in a 15-year-old girl is presented, with a summary of the available clinical data on cowpox infections.