Merkel cell carcinoma is an uncommon malignant neuroendocrine tumor that is associated with ultraviolet exposure, older age, immune suppression and polyomavirus. Merkel cell carcinoma is common in elderly females and occurs as a solitary lesion on the face and extremities. Surgery is a treatment of choice in merkel cell carcinoma, but radiotherapy or chemotherapy can also be used as an adjuvant therapy. Merkel cell carcinomas prognosis is poor and recurrence rate is relatively high, so that patients who had a lesion that suspicion of merkel cell carcinoma should undergo skin biopsy on their lesion to reduce it’s morbidity and mortality. We reported case of merkel cell carcinoma in a 87-year-old woman. She presented with a solitary, asymptomatic, erythematous indurated plaque with telangiectasia on the right cheek for 1 month. She was treated by topical steroid in other hospital but the lesion did not improve. Histopathological findings showed bowenoid change that composed of atypical cell in epidermis and small tumor cells with scanty cytoplasm and hyperchromatic nuclei arranged in dermis. Immunohistochemical study showed positivity for cytokeratin-20, CD117, BCL-2. She diagnosed with merkel cell carcinoma. We recommend excision and systemic evaluation, but she refused all treatment.