Introduction: Pyoderma gangrenosum, acne, and suppurative hidradenitis (PASH) is an autoinflammatory syndrome. Up to now no case of PASH syndrome has been reported from Iran and we report the first case in this paper. Case Presentation: In case report, we report a 44-year-old Iranian female with PASH syndrome. Her skin manifestation was first suppurative hidradenitis when she was 16 years old, then acne 20 years ago and now PG. In addition, she had history of a mass in pituitary diagnosed as prolactinoma, hormonal problems like hypothyroidism, abnormal menstrual cycles and obesity that were not reported in previous cases of PASH. It should be noted that no sign of remission and recurrence was seen in this case after 2 years. Conclusions: Further studies are being performed on the reported patient to achieve a better presentation of this disease and report the case in further papers especially with focus on laboratory and therapeutic information.