Verruciform xanthoma is a rare lesion that occurs most commonly on the oral mucosa but is occasionally seen on the skin. We present a case of multiple verruciform xanthomas occurring on the hand and foot in which there were no preexisting lesions. The current literature on this rare condition is reviewed. The cause of verruciform xanthoma is uncertain, although evidence suggests that the condition may be an unusual reaction pattern rather than a specific lesion.