Background: Paraganglioma-like dermal melanocytic tumor is a newly identified rare subtype of benign dermal melanocytic tumor. Case Report: In this report, we describe a case of an 85-year-old woman who presented with a lesion resembling paraganglioma on the heel of her left foot. Histopathological analysis revealed a striking resemblance to paraganglioma, including the "Zellballen" appearance of tumor cells. However, immunohistochemical stains such as S-100 protein, MELAN-A, and HMB-45 confirmed the melanocytic origin of the tumor cells. Conclusion: Paraganglioma-like dermal melanocytic tumor is a rare subtype of dermal melanocytic tumor that can easily be confused with other melanocytic lesions or paraganglioma. Follow-up studies have shown that this tumor typically has a benign course.