Rationale: Intravenous iron is commonly use in anemia related to chronic kidney disease. Skin staining due to iron extravasation is a rare adverse reaction that can leave a long-term staining of the skin. Presenting Concerns of the Patients: During iron derisomaltose infusion, patient reported iron extravasation. Five months after the incident, the skin stain related to the extravasation was still present. Diagnosis: A case of skin staining due to iron derisomaltose extravasation was diagnosed. Interventions/Outcomes: She was reviewed by dermatology and laser therapy was offered. Teaching Points: Patients and clinicians need to be aware of this complication, and protocol needs to be put in place to minimize extravasation and its complication.