Angiosarcoma is a highly malignant vascular tumor with an incidence of approximately one per ten million. There are three clinical variants; primary angiosarcoma, which occurs on the head and neck in the elderly; angiosarcoma in areas of chronic lymphedema; and post-irradiation angiosarcoma. Primary angiosarcoma shows variable-sized erythematous to violaceous nodules or plaques that become confluent as the lesion progress. We report a case of primary angiosarcoma of the scalp in a 76-year-old man with focal alopecia. Additional immunohistochemical stains showed perifollicular CD34 dominance, which suggested hair follicle-targeted carcinogenesis. (Korean J Dermatol 2010;48(3):206∼208)