A 53-year-old man developed bilateral hypertrichosis on the temporal and zygomatic areas of the face six weeks after undergoing orthotopic heart transplantation for ischemic cardiomyopathy. The patient’s immunosuppression regimen consisted of tacrolimus, mycophenolate mofetil, and prednisone. We suspect that the hypertrichosis was most likely secondary to tacrolimus given the timing of initiation of therapy and quick onset of hair growth, in conjunction with biologic plausibility. Still, reports of hypertrichosis secondary to tacrolimus are rare. A review of the literature revealed three additional reports of hypertrichosis attributed to topical or systemic tacrolimus. In two cases, application of topical tacrolimus on patches of vitiligo led to focal hypertrichosis or eyelash trichomegaly respectively.. In the third case, eyelash trichomegaly was observed following systemic tacrolimus for orthotropic heart transplantation. In two of the reviewed cases and in our patient, excess hair growth was first noticed within the first two months of treatment. Given that tacrolimus is commonly prescribed, an increased awareness of this likely under-reported side effect is warranted.