Paroxetine is a well-tolerated drug used in the treatment of many psychiatric disorders. In this case report, we present a 31-year old female patient with major depression who developed acute urticaria during paroxetine therapy. Our patients laboratory examinations were normal and she had no history of urticaria or other skin reactions. She also had no family history of urticaria or other skin reactions. Dermatological reactions with paroxetine are rarely seen. Most of them are eczematous and benign lesions. As in our case, urticaria is a rare dermatologic reaction with paroxetine. [Anadolu Psikiyatri Derg 2020; 21(6.000): 662-664]