Orthopedic symptoms are not rare in palmoplantar pustulosis, but standardized treatments have not yet been established.Here we report a case of palmoplantar pustulosis followed by joint pain that was successfully treated with the Kampo formulation saikokeishito. The patient was a 44-year-old Japanese man. He was suffering from pustules on the soles of his feet due to palmoplantar pustulosis, and joint pain of the sternoclavicular area, hip and lumbo-sacral area, which had not been controlled with diclofenac sodium suppositories. We prescribed saikokeishito for 1 month, and he felt less joint pain and experienced less pustulosis. After that, he suffered from an upper respiratory tract infection, and he again developed plantar pustulosis. We added kikyo (Platycodon grandiflorum root) to treat the sore throat, and his symptoms almost disappeared following this treatment. No author has reported a patient with palmoplantar pustulosis accompanied by joint pain who was treated with saikokeishito. The results experienced in this case suggest that saikokeishito could be a useful formulation for the treatment of palmoplantar pustulosis accompanied by joint pain.