Papillary endothelial hyperplasia is an exuberant, intravascular, endothelial proliferation bearing some similarities to angiosarcoma. To the best of our knowledge, it has never been described in the tongue. A case of such a lesion is herein reported. The lesion, despite its benign nature, may be clinically and histopathologically mistaken for an angiosarcoma and, thus, lead to inappropriate treatment. Papillary endothelial hyperplasia differs from angiosarcoma in its being confined entirely within large vascular lumens and in its lacking of mitosis, necrosis, and true, solid, cellular areas devoid of vascular differentiation.