We describe the case of a 35-year-old man who presented with a 4 x 4-cm ulcerated swelling over the hard palate that had progressed over 6 months. The lesion was associated with recurrent bleeding and occasional pain. Based on the lesion's clinical appearance and other characteristics (i.e., the slow progression, ulceration, and lack of regional lymphadenopathy), a provisional diagnosis of pyogenic granuloma was made, even though pyogenic granulomas of such size are rare. The mass was excised via a transoral route with a 0.5-cm margin of healthy mucosa, and the base was curetted. Histopathologic examination of the excised specimen confirmed the diagnosis. We discuss the etiopathogenesis of this entity and the various treatment options, and we review the relevant literature.