Birthmarks are among the most common types of anomalies encountered by the pediatrician in practice. Moreover, they are a source of significant concern for parents regardless of whether they are associated with an underlying systemic abnormality. Pediatricians are often called upon in the neonatal period to establish the diagnosis and direct management. Recognition of the types of birthmarks that require additional evaluation or herald a potentially problematic course is essential when examining an infant. Once an initial diagnosis is established, the pediatrician’s role is to identify the lesions that require additional evaluation or referral to subspecialists, monitor the behavior of the birthmark, and periodically reassess whether the initial.