Cutaneous larva migrans is the most common tropically acquired dermatosis caused by larvae of various nematodes, which penetrate the skin and subsequently migrate, causing serpiginous lesions and pruritus. The diagnosis is usually made clinically. While a biopsy taken just ahead of the leading edge of a lesion is felt to enhance the yield of a positive biopsy, the larvae are migratory and thus rarely identified on histologic sections. We present a case of cutaneous larva migrans in which the larval forms are well demonstrated both in a horizontal and longitudinal orientation. A 75‐year old man presented with intractable pruritus and multiple erythematous plaques on his back, poorly responsive to topical steroids. The diagnosis was made on biopsy. Associated with a perivascular lymphocytic infiltrate with eosinophils, a cross section of a larval form was identified within the epidermis. In a second biopsy, the entire organism was present within a sebaceous gland. This case clearly demonstrates the rarely identified larval forms of cutaneous larva migrans.