A pyogenic granuloma is a prevalent inflammatory hyperplasia of connective tissue. These lesions develop as a reactive tissue response to low-grade local irritation, trauma, and hormonal imbalances. Morphologically, it may present as a single exophytic nodule or sessile papule, with a smooth or lobulated surface, on a pedunculated or sessile base. These hemorrhagic lesions range in size from a few millimeters to several centimetres and vary in color from purple to pink to red, depending on the age of the lesion. Recurrence may be seen in some cases even following surgical resection and may occur due to incomplete excision, failure to eliminate etiologic factors, or repeated trauma.

This case report documents the surgical excision of a recurrent pyogenic granuloma along with the management of a liver clot that developed post-operatively.