Cutaneous vasculitic lesions offer a window to diagnosis and a ready source of accessible tissue for biopsy because the skin is commonly involved in systemic vasculitic disorders as well as in hypersensitivity states whose expression is largely confined to the skin. In this review we will consider the most common patterns of small vessel vascular disease of the skin, namely, leukocytoclastic vasculitis, urticarial vasculitis, pustular vasculitis, lymphocytic vasculitis, granulomatous vasculitis, and the mixed patterns of cutaneous vascular injury. Cutaneous vascular injury is described in the setting of drug-induced vasculitis, serum sickness, cryoglobulinemia, Henoch-Schönlein purpura, Wegener's granulomatosis, Churg-Strauss syndrome, microscopic polyangiitis, bowel arthritis dermatosis syndrome, sepsis, systemic lupus erythematosus, rheumatoid arthritis, Behçet's disease, Sjögren's syndrome, relapsing polychondritis, and cryofibrinogenemia.