Eccrine spiradenoma (ES) is an uncommon benign adnexal tumor of the eccrine sweat glands. ES clinically presents as a painful, slowly growing, erythematous to brownish subcutaneous nodule. It typically occurs on the head and trunk, but can also appears on the upper and lower extremities. ES arises mostly in middle-aged adults without sexual predilection. Histopathologic finding of the ES reveals multinodular sharply-circumscribed tumor in the dermis. The tumor is composed of two cell types, peripheral small basaloid cells with hyperchromatic nuclei and central large cells with pale nuclei, which may form pseudorosettes. Treatment of choice is surgical excision and recurrence is uncommon. A 44-year old woman presented with 20-year history of a painful 1.5 Ⅹ 0.7 cm sized brownish smooth surfaced subcutaneous nodule on the proximal interphalangeal joint area of left thumb. Histopathologic findings from the excised specimen showed sharply-demarcated tumor arranged in sheets in the dermis, which was composed of central pale large cells and outer hyperchromatic small basaloid cells. The patient was diagnosed with eccrine spiradenoma. Herein we report a rare case of eccrine spiradenoma on the left proximal interphalangeal joint area of thumb.