Mongoloid spots are common in children from many different racial backgrounds. These patches of dermal melanocytosis are found in greater than 90% of African Americans, 81% of Asian, and 70% of Hispanic infants. Although they are often seen in the lumbosacral and gluteal areas they are not limited to those regions. They need to be distinguished from bruises of child abuse. Compared to a bruise they are more uniform in skin color, their borders are better defined, there is no induration or tenderness and they are stable over time.