Bacillary angiomatosis is the development of vascular-rich papules and nodules in response to proliferation of bacteria from the genus Bartonella. We report a case of bacillary angiomatosis in an HIV-infected male that presented as firm, vascular papules on the upper lip recalcitrant to prior treatments. Histopathologic examination showed an inflammatory infiltrate surrounding vascular proliferation and Warthin Starry Stain revealed numerous rod-shaped organisms. Serologies were positive for B. henselae IgG and resolution occurred following treatment with oral antibiotics. J Microbiol Infect Dis 2021; 11(2):115-116.