Epidermoid cyst is a common skin lesion. However, in areas where the skin is tightly adherent to the bone, a portion of the epidermis may be implanted into the bone traumatically or a subcutaneous epidermoid cyst may penetrate the bone cortex. Intraosseous epidermoid cyst is rare, and arises almost exclusively in the skull and phalanges of the hand. In the hands, terminal phalanx is involved in almost all cases. Differential diagnosis includes glomus tumor with bone erosion, enchondroma, osteomyelitis, aneurysmal bone cyst and metastatic tumors. We experienced a case of intraosseous epidermoid cyst in the distal phalanx of a 28-year-old woman, who had injured her finger about 20 years ago. We report the clinical, radiographic and pathological findings in detail.