The patient was a 24-year-old male who complained of urticaria upon exposure to cold air and after showering in cold water. Allergic skin tests were positive for cockroach. To determine whether he had cold urticaria, we performed an ice cube test. The patient complained of pruritus, erythema, and wheals appeared at 10min. Skin biopsy specimens collected 10 minutes after ice-cube test showed perivascular mononuclear cell infiltration and edema in hematoxylin and eosin stains, and metachromatic cell and degranulation in toluidine blue stain.