Objective: To explore the clinical and pathological features, diagnosis and differential diagnosis of eccrine poroma (EP). Methods: Clinical characteristics and pathological morphology were analyzed in 32 cases of EP, with immunohistochemical staining (3 cases), and review of the relevant literature. Results: EPs clinically presented as solitary flesh-colored or pigmented papule, plaque, or nodule with a smooth or verrucous surface, appeared most commonly on the extremities or limbs, followed by the trunk, head or face of middle-aged to elderly men and women. It was easily misdiagnosed as seborrheic keratosis, granuloma, pigment nevus, verruca, melanoma, etc. EPs histologically were well-circumscribed tumor composed of proliferative cuboidal or poroid cells with monomorphous ovoid nuclei, a highly vascularized stroma, ductal differentiation, occasionally cyst formation, visible focal necrosis, mitotic activity and clear cell change. It commonly extended from the basal epidermis into the dermal layer. Immunohistochemical staining showed p63, CK14 and CK5/6 were positive, EMA and CK7 focally and weakly positive, Ki-67 positive rate was about 3%–5% for the tumor cells, while CK19 and CEA was positive, CK7 and EMA weakly positive for tumor ductal structure, and S100 was positive for dendritic melanocytes scattered within intraepidermal tumor nests. Conclusion: Given the rarity of these neoplasms and lack of typical presentations, eccrine poroma is easily misdiagnosed as similar cutaneous lesions and correct diagnosis relies mainly on histopathology observation, as well as immunohistochemical staining is auxiliary in the differential diagnosis. Although the tumor is benign and can be cured by surgical excision, a few persistent poroma may turn malignant, so suspicious cases need long-term follow-up.