Like all organ systems, the skin undergoes significant changes during pregnancy. The majority of physiologic skin conditions related to gestation resolve after childbirth. However, they may cause significant concern or cosmetic distress or be mistaken for one of the specific dermatoses of pregnancy. Dermatoses unique to pregnancy are rare but important to recognize because they may be intensely pruritic or painful to the mother, and they may pose significant risks to the patient, her fetus, or both. Clinicians familiar with the cutaneous manifestations of pregnancy can most effectively treat and counsel patients, guide expectations, and avoid unnecessary diagnostic tests and therapies. This review summarizes physiologic skin changes in the gravid patient and the specific dermatoses of pregnancy.