Calibre persistent labial artery is a vascular lesion in which a large diameter artery penetrates the submucosal tissue of the lip and continues without division or decreasing its size. Usually, a calibre persistent artery of the lip presents as a pulsatile papule and is easily misdiagnosed. Although the diagnosis can be clinical, the development of high-resolution colour Doppler ultrasound is a useful non-invasive tool for evaluating the lesion. We report a case of a 2-year-old male patient presenting with a congenital pulsatile lesion on his upper lip. Clinical diagnosis of a calibre persistent artery of the lip was confirmed by colour Doppler ultrasound. Images are provided to highlight findings of the physical and ultrasound examinations.