A previously healthy, 26-year-old heterosexual man experienced necrotic penile ulcerations with fever, rigors, and difficulty voiding. Urethral instrumentation and treatment with antibiotics were associated with progression of the disease. Type 1 herpes simplex virus was isolated from the penile ulcerations and pustular lesions in the groin and antecubital fossae. Recovery was complicated by a urethral stricture requiring surgical treatment. Herpes simplex type 1 must be considered in the differential diagnosis of severe penile ulcerations; isolation of herpesvirus from such lesions may obviate further diagnostic and therapeutic measures that are unnecessary and, in some cases, counterproductive.