Abstract Neutrophil recovery after autologous hematopoietic cell transplantation (ASCT) is affirmed with achievement of an absolute neutrophil count (ANC) of ≥500/µL. There is growing evidence that neutrophils may be observed despite undetectable peripheral ANC counts following autologous hematopoietic cell transplant and are preferentially delivered to sites of inflammation. We report an interesting case that confirms neutrophil tissue delivery to the skin two days prior to evidence of blood engraftment after an ASCT.