Pyoderma gangrenosum (PG) is a neutrophilic dermatosis that is a rare complication of surgery. Its diagnosis and treatment often are delayed in the postsurgical setting; by the time a dermatologist is consulted, lesions often are quite large and may be accompanied by systemic symptoms. Prompt treatment of severe PG with systemic therapy is warranted; however, in patients with contraindications to systemic immunosuppressive agents, treatment with superpotent topical corticosteroids may be considered. We present a case of PG following gastric bypass surgery along with a review of the literature on postsurgical PG.