Erythroderma is a dermatologic emergency with potentially serious consequences. Several diseases with different etiologies characteristically appear as erythroderma. Depending on the age groups, congenital ichthyosiform disorders, infections, preexisting dermatoses, drug eruptions, and internal malignancies commonly present with, or progress to, erythroderma. The course, prognosis, and management strategies also vary depending on the cause of erythroderma; hence, an accurate diagnosis is essential in minimizing associated morbidity and mortality. The generalized erythema and scaling often obscure the classic clinical features of the underlying skin diseases, posing a diagnostic challenge to dermatologists. Awareness and elicitation of subtle signs and clinical manifestations are crucial. A step-wise approach ensures completeness of clinical evaluation and avoids missing any relevant clinical data. The initial clinical presentation, cutaneous examination findings, and systemic clues reveal important information regarding the diagnosis, course, and prognosis of erythroderma. The age at onset, symptomatology, duration of illness, initial lesions, initial site of onset, clinical course, family history, types of scales, changes in cutaneous integuments and systemic clues will assist in delineating the nature of underlying disease.