Cutaneous arteriovenous haemangioma (AVH) is a rare benign vascular lesion, which typically occurs on the head and neck. Its aetiology is unclear but thrombosis, trauma, infection or endocrine triggers have been proposed. We report the case of a 64-year-old female presenting with acquired AVH of the upper lip following oral herpes simplex virus infection. This is the first documented occurrence of AVH as a post-herpetic isotopic response (PHIR).