Abstract: Cutaneous clear cell neoplasms represent a heterogenous group of several primary and metastatic tumors with diverse histogenesis. Tumors with widespread clear cell change can seem strikingly similar under the microscope resulting in diagnostic difficulties. Although most cases are idiopathic, intracytoplasmic accumulation, artifact of tissue processing, and degenerative phenomenon have been cited as possible causes of clear cell change. An awareness of the various entities demonstrating this attribute, judicious use of ancillary techniques, and knowledge of the clinical setting are crucial to the accurate diagnosis. This review details the histological features of clear cell neoplasms of the skin with particular emphasis on the discriminating features.