Lenalidomide, a derivative of thalidomide, is an immunomodulatory agent introduced in 2004 for the treatment of multiple myeloma in combination with dexamethasone. It is also indicated for the treatment of myelodysplastic syndrome and is currently under investigative use for metastatic melanoma. We present a case of neutrophilic dermatosis involving predominantly the lower extremities in a patient receiving lenalidomide therapy for multiple myeloma.