OBJECTIVE Tattooing or dermatography for cosmetic and reconstructive purposes continues to grow in popularity because of its ability to easily alter appearance. Though licensed professionals perform some procedures, amateurs lacking formal training still place many tattoos. There is a multitude of unforeseen complications resulting from tattooing, which have been detailed in the medical literature for a number of years. Despite awareness of adverse reactions, there is a lack of basic science research with respect to tattooing. Medical practitioners are faced with diagnosing and treating complications of tattooing. A review of recent tattooing literature is useful, although most of it exists as case reports. RESULTS Recent findings focus on the adverse outcomes of tattooing and their management. Methods of tattoo removal and resultant complications along with patient disease resulting from tattoo placement continue to be well published topics. CONCLUSIONS A review of the recent literature pertaining to cosmetic and reconstructive tattooing results in an emphasis on complications and management. Despite the number of published case reports detailing the adverse outcomes of tattoos, there continues to be a lack of fundamental research about the topic.