Henoch-Schönlein purpura (HSP) is the most common form of systemic vasculitis in childhood and a small percentage of children develop a chronic form of the disease that often requires prolonged corticosteroid therapy. A detailed case description of a child with non-renal chronic HSP treated with methotrexate to allow for tapering of corticosteroids is presented. This represents the first report of methotrexate use in the treatment of chronic HSP.