Recurrent oro-genital ulceration is a common condition of unknown aetiology. This paper describes a patient who had severe recurrent oro-genital ulceration which was unresponsive to conventional therapy. The patient was taking non-steroidal anti-inflammatory drugs (NSAIDs) prescribed for osteoarthritis. When she stopped this medication, she had no further genital ulceration and the pattern of her oral ulceration was dramatically improved. There have been no previously reported cases of recurrent oro-genital ulceration associated with NSAIDs.