Eosinophilic fasciitis is a syndrome that is characterized by induration of the skin, peripheral eosinophilia, and a good clinical response to corticosteroid therapy. A skin biopsy specimen from a 69-year-old man who died four months after diagnosis of eosinophilic fasciitis showed that vessel walls in the fascia were invaded by inflammatory cells; endothelial cell proliferation appeared to lead to obliteration of the lumen. No evidence of internal organ involvement was noted at postmortem examination. These findings suggest that, although cutaneous vasculitis may play a role in this disorder, lack of visceral involvement and generally benign course of the disease dictate conservative therapy.