Eccrine angiomatous hamartoma is an uncommon benign cutaneous lesion composed of proliferating eccrine structures associated with vascular channels. It usually appears during infancy or childhood and most often affects distal parts of the limbs. We describe a 13-year-old boy who presented to the dermatology clinic in March 2023 with a slowly enlarging swelling on the medial aspect of the right ankle that had been present since early childhood. The lesion measured approximately 7 × 7 cm and had become painful over the preceding two years. The patient had previously undergone surgical removal in 2020, but the lesion reappeared within six months. Clinical examination revealed a violaceous irregular plaque extending towards the plantar surface. Histopathology demonstrated numerous eccrine coils within the dermis associated with multiple thin-walled vascular channels, consistent with eccrine angiomatous hamartoma. Intralesional 3% polidocanol sclerotherapy was administered, resulting in marked reduction in lesion size and tenderness during follow-up.