BACKGROUND: Hair tourniquet syndrome involves fibers of hair or thread wrapped around an appendage producing tissue necrosis. Appendages commonly involved include the toe, finger, and penis. We report a hair tourniquet resulting in amputation of the clitoris. CASE: An adolescent presented with a 4-year history of intermittent genital pain that increased in severity over the preceding 5 days. Physical examination revealed a necrotic clitoris surrounded by a black hair. During the examination, the tissue fell off resulting in immediate improvement in the patient’s pain. CONCLUSION: We report a case of a clitoral hair tourniquet syndrome leading to autoamputation of the clitoris. A high index of suspicion for this condition is important because of the potential consequences of delayed treatment.