Mycetoma is a chronic granulomatous suppurative disease of the skin and underlying tissue caused by saprophytic fungus (eumycetoma) or actinomycetes (actinomycetoma). Despite having a low prevalence and low mortality rate, mycetoma may cause serious complications such as deformity and disability due to destruction of skin and adjacent structures. Various therapeutic options call for a thorough diagnostic approach before initiating therapy. Prompt treatment is imperative to limit disabilities Furthermore, mycetoma is prone to recurrences, hence rigorous assessment of therapeutic goal is essential. We reported a case of actinomycetoma confirmed by histopathology examination and successfully treated with combination of rifampicin and cotrimoxazole. © 2024 Pakistan Association of Dermatologists. All rights reserved.