We describe a bacillus Calmette-Guérin (BCG) granuloma that occurred during the course of Kawasaki disease. A 12-month-old male infant with Kawasaki disease had an erythematous indurated plaque with prominent necrotic ulceration at the BCG vaccination site on the left upper arm. Histologic study showed a granulomatous reaction consisting of epithelioid histiocytes, lymphoid cells, and Langhans-type giant cells. No evidence of mycobacterial infection was obtained. The lesion healed completely within 2 weeks without administration of antituberculous agents. We believe that the granulomatous reaction occurred as a result of hypersensitivity to proteins in the BCG vaccine, which appeared after the onset of Kawasaki disease.