A 61-year-old female with a 4-year history of disseminated granuloma annulare was successfully treated with the antitumor necrosis factor (TNF)-alpha antibody, adalimumab. The patient had failed high potency topical glucocorticoids, hydroxychloroquine, and narrow-band ultraviolet light (UV)-B phototherapy. Anti-TNF-alpha therapy may be a therapeutic option in patients with disseminated granuloma annulare poorly controlled with conventional medications.