Actinomycosis is a chronic and suppurative infection caused by an endogenous Gram-positive bacterium. The usual sites of infection are the head and neck, thorax, and abdomen. Primary cutaneous actinomycosis is very rare and usually associated with external trauma and local ischemia. We report on the case of a primary cutaneous actinomycosis of the thigh in a 34-year-old man. The patient was treated successfully with surgical resection and combined antibiotic therapy, and eventually cutaneous reconstructive surgical procedure.