Giant pigmented nevi are congenital melanocytic nevi <1/20,000 births. The appearance of pigmented nevi at birth is not common place. Only 3% of infants are in born with visible nevi. Here we report a case of a 1 year old female child who presented to us with a large black patch over her back extending up to buttocks with multiple satellite lesions all over the body, since her birth. Their management is a challenge for the treating dermatologist owing to their large size and a propensity to recur. However, there have been recent advances in the field with many new therapeutic modalities available.