We report a case of granulomatous lesion in the upper lip which was histopathologically diagnosed as lupus miliaris disseminatus faciei (LMDF). A 59-year-old woman had two small nodes with pain in the upper lip for 2 months. The pathological finding demonstrated that many granulomatous lesions composed of epitheloid cells and Langhans-type multinucleated giant cells were formed in the dermis. In some lesions, central necrosis was also observed. Other investigations, including chest X-ray examination and cultures of bronchial secretions, showed no evidence of tuberculosis (T. b.). Angiotensin I converting enzyme in the serum, which is widely used to diagnose sarcoidosis, was within normal range. Tuberculin test (PPD 0.05 μg/0.1 ml) was positive. Since there was no obvious evidence of T. b. or sarcoidosis, she was finally diagnosed as LMDF mainly from the histopathologic features. She is well and shows no sign of recurrence 7 months after surgical treatment.