This report describes three cases of localized or regional herpes simplex virus lymphadenitis. Of the two patients who presented with inguinal lymphadenopathy, one had a localized rash prior to the development of lymphadenopathy, and the other developed a genital rash 2 days after lymph node biopsy. The third had occipital lymphadenopathy and concurrent localized occipital herpetic folliculitis. Localized herpes simplex virus lymphadenitis appears to be a specific clinicopathological entity. Histologically, it is characterized by varying degrees of follicular and paracortical hyperplasia, a prominent immunoblastic response and perinodal inflammation. Viral inclusions with or without focal necrosis in the lymph node may be seen, and immunostaining for viral antigen may be seen in paracortical cells.