Almost nothing is known about why pigmented birthmarks (moles or nevi) occur in particular locations of the skin. The causes of most birth defects are also unknown. About 35% of children who claim to remember previous lives have birthmarks and/or birth defects that they (or adult informants) attribute to wounds on a person whose life the child remembers. The cases of 210 such children have been investigated. The birthmarks were usually areas of hairless, puckered skin; some were areas of little or no pigmentation (hypopigmented macules); others were areas of increased pigmentation (hyperpigmented nevi). The birth defects were nearly always of rare types. In cases in which a deceased person was identified the details of whose life unmistakably matched the child’s statements, a close correspondence was nearly always found between the birthmarks and/or birth defects on the child and the wounds on the deceased person. In 43 of 49 cases in which a medical document (usually a postmortem report) was obtained, it confirmed the correspondence between wounds and birthmarks (or birth defects). There is little evidence that parents and other informants imposed a false identity on the child in order to explain the child’s birthmark or birth defect. Some paranormal process seems required to account for at least some of the details of these cases, including the birthmarks and birth defects.