Background: Skin being the major organ of human body, any lesion on the newborn can cause concern and anxiety to parents. Many such lesions can be physiological and transient. There are very few reports in the literature regarding the cutaneous manifestations in newborns in India. Aim:This study is undertaken to determine the prevalence and pattern of various skin lesions in neonates and to correlate the relationship between new born skin lesions to gestational age, birth weight, mode of delivery, sex and maternal factors. Materials and methods:All new born delivered at a referral hospital between 2013-2015 were included for the study. Data regarding maternal age, illness, drugs, gestational age, mode of delivery, birth weight, sex of new born were noted. All the new born were clinically examined for skin lesions during their stay in hospital.Results: Total of 1427 live births was included. Out of this 92.1% of newborns had skin lesions and 7.9% had no skin lesions. The incidence of single lesion was 25.4% and multiple in 66.5%. Common manifestations included mangolian spots, milia, ebstein pearls, erythema toxicum neonatorum. Our study showed increased incidence of mangolian spots, lanugo hairs and cutis marmorata in new-borns of mothers having illness and in preterms. Birth injuries were more in instrument assisted deliveries. The skin peeling and birth marks were more in posterms. However there was no difference in the manifestations between male and female babies. Conclusion:Majority of the skin lesions are transient and physiological which does not require any treatment. Recognizing these transient lesions in new born will avoid unnecessary therapy to the new-borns and it will enable the paediatrician to allay parental concern and anxiety.