Retinoids are metabolites and synthetic analogs of vitamin A (retinol) that are not only commonly used in dermatologic practice, but are also irreplaceable in the treatment of many diseases, including acne and psoriasis. The primary drugs in this group include isotretinoin, acitretin, bexarotene, and alitretinoin. All retinoids are in the X class in pregnancy, indicating that no pregnant woman or someone intending to become pregnant would have these agents prescribed. Isotretinoin has important mucocutaneous, metabolic, and teratogenic side effects. Acitretin has significant metabolic, skeletal, and teratogenic side effects. Alitretinoin is indicated for the treatment of chronic hand dermatitis that is refractory to potent topical corticosteroids in adults. The rate of response to treatment increases with an increased dose of bexarotene. Isotretinoin, acitretin, bexarotene, and alitretinoin have important mucocutaneous, metabolic, and teratogenic side effects. All retinoids are teratogenic; appropriate precautions and close follow-up should be undertaken in women of childbearing potential.