BACKGROUND:Endocrinological disorders occasionally present with cutaneous manifestations. Thyroid hormonal abnormalities are frequently associated with abnormalities of the skin, hair and the nails. AIM: To study the various dermatological manifestations of hypothyroidism and to identify various associations with hypothyroidism in a tertiary hospital in South India from September 2014 to March 2015. RESULTS: In a total of 56 patients studied, cutaneous changes were seen in 83.92 percent of the patients. Male is to female ratio of hypothyroid patients studied was 1:4.6. 17.85 percent of the total patients were males and 66.07 percent of the female patients showed cutaneous features of hypothyroidism. The commonest general symptoms seen in our study were weight gain and fatigue. Xerosis/Ichthyosis, pedal oedema, facial puffiness and hair changes were the common cutaneous features seen in our study. Urticaria, vitiligo, acanthosis nigricans, melasma and pemphigus foliaceous were the few cutaneous associations of hypothyroidism in our study whereas diabetes mellitus, microcytic hypochromic anaemia and hyper-cholesterolaemia were the systemic features associated with hypothyroidism in our study. CONCLUSION: Patient with hypothyroidism most commonly present with xerosis/ichthyosis and pedal oedema and more commonly associated with urticaria, vitiligo, acanthosis nigricans and melasma. KEYWORDS: Cutaneous Manifestations, Hypothyroidism. INTRODUCTION:It's a well-known fact skin is referred to as window to the body. Many internal ailments are detected by looking for the various cutaneous signs and symptoms. Dermatologists often see skin lesions that suggest an underlying endocrine disorder. Identifying the endocrine disorder is very important, so that patients can be treated appropriately rather than giving symptomatic treatment. The endocrine system consists of hormone producing glands, including the pituitary, pancreas, thyroid, parathyroids, adrenals, testes and ovaries. A failure in any of these glands may clinically present as an endocrine disorder. Hormones are essential in regulating physiologic processes in each system of the body, including the skin. Endocrine hormones when in excess or deficient result in changes in cutaneous morphology and function.They act as chemical messengers that serve to regulate growth, metabolism, reproduction, behavior and development. Underlying endocrine disorders which may present as skin diseases are, diabetes mellitus; thyrotoxicosis; hypothyroidism; Cushing syndrome; Addison disease; acromegaly; hyper and rogenism; hypopituitarism; primary hyperparathyroidism; hypoparathyroidism 1 . Like most systemic pathologies, hypothyroidism is expressed in multiple ways through the skin and its adnexa. In some patients, the initial and most prominent complaints are related to alterations in the skin, and hence the dermatologist will at times be the first physician to be consulted. To make a diagnosis of the underlying endocrinopathy is essential, so that patients can receive corre...