Perineurioma (PN) is an uncommon benign tumor originating from the peripheral nerve sheath and composed solely of perineurial cells. Most PNs occur sporadically and are typically described as painless masses. This report presents an atypical case of extraneural or soft tissue PN (ESTP) in a 37-year-old Filipino female with a history of trauma. The patient presented with a 5-month history of a gradually enlarging nodule on her right thumb accompanied by localized dull pain. Physical examination revealed the presence of an ill-defined, slightly erythematous, firm, movable, and tender nodule. Histopathological analysis demonstrated characteristic features of ESTP, including spindled cells arranged in a whorled pattern. Immunohistochemical staining for epithelial membrane antigen was positive, while S-100 staining was negative, which confirmed the diagnosis. The nodule was successfully excised without any complication. There was no recurrence observed during the 4thmonth postexcision. This case highlights the importance of considering ESTP as a potential diagnosis for painful masses following trauma and suggests a possible association between ESTP and trauma. Surgical excision remains the preferred treatment option for ESTP, and recurrences are infrequent.