Background: Skin tags (achrochordons, fibroepithelial polyps) are pedunculated lesions which commonly occur in areas of skin fold such as the neck, the axillae, the eyelids. Case Presentation: Herein a large achrochordon of the left labium majus is presented. Total excision of the lesion was performed and histopathology confirmed the diagnosis of achrochordon. Conclusion: Large skin tags on genitourinary region can be confused with a malignancy. Excision of these types of skin tags is recommended for pathological examination.