Skin is not only the largest organ system in the body but also an important defense system. A newborn's skin goes through many changes both in appearance and texture. Physiological and transient skin lesions are noticed during this neonatal period. Some of the physiological skin lesions in newborns which usually require observation and no treatment are vernix caseosa, physiological scaling of the newborn, harlequin color change etc. Our aim is to recognize and study the various patterns of skin lesions that occur in neonates. For our cross sectional hospital based study, 120 neonates were selected from the dermatology OPD and Neonatal Intensive Care Unit, pediatric and postnatal ward of our teaching hospital.. We found that there is an increase in physiological skin lesions like Mongolian spots(77.5%),Epstein pearls (50%),followed by vascular lesion like Salmon patch (25%),and transient skin lesion like erythema toxicum neonatorum (24.2%). Most of the physiological and transient skin lesions disappeared with time without any treatment. It is also important to differentiate between benign physiological and transient cutaneous lesions as compared to pathological conditions like infections.