Background: Skin tags (STs), also known as acrochordons, are the most common fibro epithelial skin tumours. Connective tissue growth factor (CTGF) is a novel peptide that exhibits platelet-derived growth factor-like activities and is produced by skin fibroblasts after activation with transforming growth factor-beta (TGF-β). The aim of this research was to evaluate the immunohistochemical expression of connective tissue growth factor in skin tags to provide an insight about its role in the pathogenesis of the disease. Methods: This prospective case-control research was carried out on 20 skin tags' cases clinically and histopathologically diagnosed, and 10 healthy individuals of matched age and sex, served as control group. All cases were subjected to dermatological examination, skin biopsy and immunohistochemical staining.Results: There was significant difference between the cases and controls regarding epidermal (Acanthosis, hyperkeratosis, papillomatosis) and dermal changes (perivascular inflammatory infiltrate, fibroblasts, collagen arrangement) (P value <0.05). There was a statistically significant difference in CTGF staining pattern between STs and normal skin (P. value <0.001). There were insignificant relationship between CTGF immunoexpression score (IRIDI score) and each of gender, age or BMI of cases with STs. Insignificant relation was found between site of STs and intensity of CTGF immunoexpression score (IRIDI score). Conclusions: CTGF immunohistochemical expression was increased in STs which could be incriminated in its pathogenesis through its role in fibroblast proliferation, angiogenesis and collagen synthesis and deposition.