NF1 is an autosomal dominant disorder primarily affecting the development and growth of nerve cell tissues. It is known that various kinds of pigmented skin lesions are associated with neurofibromatosis (NF), including café-au-lait spots, axillary freckles and hyperpigmentation overlying plexiform neurofibromas. In addition, associations of NF with naevus spilus, naevus of Ota, segmental unilateral melanosis and congenital giant melanocytic naevus have been anecdotally described. We present a rare case of hyperpigmentation overlying plexiform neurofibroma in the waist and buttock of a woman with NF1.