Cutaneous small vessel vasculitis is generally manifested as palpable purpura on dependent areas of the body such as the lower extremities and sites covered by tight clothing. Classically involving both sides of the lower limb, cutaneous vasculitis with predominantly unilateral involvement have been rarely reported. A 77-year-old woman presented with painful, multiple, erythematous to purpuric papules on the left leg that appeared 2 days ago. The lesion had been rapidly progressed. The patient was consistently consuming oral warfarin to control the lymphedema of the left leg that occurred after surgery for cervical cancer 20 years ago. Laboratory findings showed mild elevation of liver enzyme, otherwise in normal range. Histological examination was consistent with leukocytoclastic vasculitis. The patient was diagnosed as cutaneous vasculitis, and was treated with oral methylprednisolone (0.5 mg/kg/day). This dose was maintained for 1 week and then was tapered over the next 3 weeks. A progressive resolution of the rash was observed. Unilateral vasculitis has been associated with underlying diseases such as infection, lymphedema, and immobilization. In this case, the patient developed chronic lymphedema, which is associated with hydrostatic pressure and stasis in the pathogenesis. Herein, we report a rare case of unilateral cutaneous small vessel vasculitis in the patient with chronic lymphedema.