Vascular and pigmentary lesions compromise most birthmarks. Lesions range f
rom uncommon, to very common, some being essentially normal variants. The n
atural history of these varies from being transient phenomena of no signifi
cance to permanent cutaneous findings that may be associated with significa
nt systemic complications or diseases. This article describes the most freq
uently encountered clinically important birthmarks, including congenital ne
vi, hypopigmented lesions, vascular malformations and hemangiomas, discussi
ng clinical presentation, diagnosis, and findings that should prompt early
assessment and treatment.