Drug photosensitivity is a relatively frequent adverse event, although not always recognized due to its clinical polymorphism and difficulties in performing tests to prove drug causality.The aim of this report is to review the mechanisms of photosensitivity related with topical and systemic drugs (phototoxicity, photoallergy, autoimmunity, and enhanced photocarcinogenesis), the main acute and delayed clinical manifestations (acute sunburn or eczema, pseudoporphyria, photo-onycholysis, dyschromia, telangiectasia, subacute lupus erythematosus, pre-cancerous lesions, and cutaneous neoplasia), the main culprits [non-steroidal anti-inflammatory drugs (NSAIDs), antimicrobials, like fluoroquinolones and tetracyclines, psychotropic, anticancer, and cardiovascular drugs] and the most adequate diagnostic procedures (photopatch and drug photoprovocation tests).