Extravasation of contrast medium is a complication of contrast-enhanced computed tomography studies. Clinical presentations include minimal swelling, erythema and, when the extravasated volume is large, ulceration, compartment syndrome, and skin necrosis. Here we present an 80-year-old woman with progressive swelling and extensive soft tissue necrosis of the dorsal left hand due to contrast medium extravasation. After treatment by skin graft, she showed no long-term complications. Patients at risk for contrast medium extravasation should be closely monitored and appropriately managed.