With the growing popularity of cosmetic procedures in those with darker skin types, it is increasingly important to acknowledge differences in management, and to discuss current literature and guidelines to reach this population. This review summarizes the current primary literature on the four most commonly performed cosmetic procedures in ethnic skin, with an emphasis on safety and efficacy. These procedures include: laser hair removal, microneedling, chemical peels, and fillers or injectables. While we can conclude that these procedures are generally welltolerated by darker Fitzpatrick skin types, best practices are still lacking, and there is limited information on the management of post-procedural adverse events. Overall, treatment should be individualized while giving special considering to the Fitzpatrick skin types III-VI patients' tendency to develop dyspigmentation, scarring/keloids, or measurable results.