Abstract: Anthrax is a zoonosis caused by Bacillus anthracis, which is mainly skin anthrax and belongs to the legal class B infectious disease in China. A 33-year-old male patient presented with a rash on his right forearm after insect bite. After the rash is broken by himself, it appears redness and blisters with a small amount of pus. The result of conventional microbial culture was negative, while the metagenomic next-generation sequencing (mNGS) of blood sample revealed Bacillus anthracis. This study discusses the clinical application value of mNGS from the perspective of early diagnosis of cutaneous anthrax and the prevention and control of nosocomial infection.