Bowen's disease also known as bowenoid keratoses, presents as a clinically persistent, progressive red scaly, or crusted plaque which is due to intraepithelial carcinoma and is potentially malignant. Lesions are typically asymptomatic but may be associated with bleeding. We are reporting perianal Bowen's disease in a 30-year-old married HIV-infected male which is excised and underlying healthy ulcer grafted.