Nevus of Ota is another “black” birthmark that is more common in children. Because of the deep pigmentation, most children have a “cyanotic” clinical appearance, so it is also known as a brown-cyanotic nevus on the palate of the eye. (1) About 50% of children have them after birth, while others have them within one year of age, and occasionally they appear later or during pregnancy. (2) The birthmark is located in the distribution area of the trigeminal nerve on the face and often involves the upper and lower eyelids, zygomatic area and temporal area on one side of the face, and some babies can have ipsilateral sclera involvement. If the lesions are extensive, they may even spread to the cheeks, forehead, scalp, nose and ears. Occasionally, the lesions may be bilateral. (3) The lesions are brown, greenish-gray, blue, black or purple patches, which may be reticulated or map-like in distribution, with occasional nodules. (4) Most of the lesions do not heal spontaneously and may be at risk of exacerbation during adolescence. (5) If the nevus is located on the shoulder, upper arm, posterior supraclavicular and lateral arm innervation areas, i.e. shoulder and upper arm deltoid area, it is clinically called “Ito nevus”. Both nevus of Ota and nevus of Ito can be treated with 694nm Q-switched ruby laser, 755nm Q-switched emerald laser or 1064nm Q-switched Nd:YAG laser. Generally, 3-6 treatments are needed, with an interval of about 3 months each.