Ecthyma contagiosum (orf), a viral disease endemic to sheep and goats, can be zoonotically transmitted to humans through contact with infected animals. While the disease is common among sheep and goat herders worldwide, it comes to medical attention infrequently since it is generally a mild self-limited illness. We recently treated a healthy 36-year-old female who presented with bullous lesions on her fingers and a diffuse macular rash which had developed after antibiotic therapy for her bullae. She had been caring for her neighbor's goats which had recently been ill with "sore mouth." We discuss this case of orf and review the medical literature on this self-limited illness uncommon to the midwestern United States.