Tenoxicam has been associated with cutaneous adverse reactions, and it is categorized as a non-steroidal anti-inflammatory drug (NSAID) within the oxicam class. Herein, we report a patient with tenoxicam-induced fixed drug eruption (FDE) confirmed with patch testing. FDE is a delayed type hypersensitivity reaction frequently caused by antimicrobials and NSAIDs. Cross-reactivity may occur among the oxicams, and alternative medications should be carefully selected. This report highlights the importance of patch testing in identifying the causal drug in FDE, and the rise in awareness of tenoxicam as a potential trigger.