Introduction: Phrynoderma, meaning toad skin, is a form of follicular hyperkeratosis. Multiple nutritional deficiency disorders have been implicated in the etiology of phrynoderma. It is commonly seen in the children belonging to low socio-economic strata, clinically characterized by discrete, follicular, skin colored papules with keratotic plugs distributed over elbows, knees, extensor extremities and buttocks. The present study aims to determine the clinical presentation and associated nutritional co morbidities in diagnosed phrynoderma cases. Materials and Methods: A series of 339 clinically diagnosed phyronderma cases attending the Nutrition Unit of tertiary care hospital during a period from September 1995 to March 2014 were retrospectively reviewed. All cases were reviewed for clinical history, cutaneous examination findings including associated signs of nutritional deficiencies. Results: In a total of 339 patients of Phrynoderma studied, there were 195 males and 144 females. Majority of patients were in 6-10years age group. The lesions were distributed bilaterally and symmetrically in 196 (57.8%) patients. The lesions were localized predominantly to elbow followed by extremities in upper body and knees in lower body followed by buttocks. A total of 16.2% patients had associated ocular and skin findings and 13.3% of patients had the signs of Vitamin A deficiency. Conclusion: Phyrnoderma is a disorder of young children and adolescents and can be considered as multifactorial disease involving deficiencies of various nutrients along with local factors such as pressure and friction responsible for pathogenesis of the disease.