We report a patient with rheumatoid arthritis who had a chronic leg ulcer with long-standing resistance to therapy. Topical basic fibroblast growth factor (bFGF) at a dose of 30 micrograms/day for 3 months was clinically effective in reducing the ulcer area by promoting angiogenesis, re-epithelization, granulation and scar formation. bFGF may be an effective treatment for therapy-resistant leg ulcers.