During July-October 2004, 19 (18 calves, 1 yearling) free-ranging musk oxen (Ovibos moschatus) at Dovre, Norway, were observed with contagious echtyma-like lesions, and 16 of them were euthanized. Six musk oxen were subjected to necropsy, histopathological and microbiological examinations. All euthanized animals had lesions consistent with contagious ecthyma presenting as wart-like, scabby lesions on the muzzle, lips, oral mucosa and limbs to a variable extent. The histopathological examination showed pustular dermatitis characterized by epidermal proliferation, reticular degeneration, degenerating keratinocytes with intracytoplasmic eosinophilic inclusion bodies, vesicopustules, microabscesses and multifocal ulcerations in the epidermis which was covered by a serocellular crust. Pathology and bacteriology showed evidence of secondary infections in the skin and draining lymph nodes. Electron microscopy (negative staining) of lesions from four animals detected parapoxvirus with the typical arrangement of the outer protein filaments. Parapoxvirus DNA was detected in tissue samples from two examined animals by polymerase chain reaction (PCR) with primers from the B2L-gene. A DNA sequence of 326 nucleotides from the amplicon was compared with similar DNA sequences from parapoxvirus isolated from sheep, reindeer, musk ox and cattle. The outbreak was caused by a virus similar to other circulating orf virus variants in Norway. Antibodies against parapoxvirus were detected with a virus neutralization test in 3 of 35 musk oxen (8.6%) sampled at Dovre between 2004 and 2006. This is the first report of a severe outbreak of contagious ecthyma in free-ranging musk oxen.