Tattooing is getting increasingly popular among the young. However, not everyone is suited to getting tattooed. Indeed, it is not rare for patients with a chronic skin disease or another systemic condition to be eager to get a tattoo. They perceive tattooing as a harmless, risk-free procedure. Therefore, some patients may not seek medical advice before the procedure. Some also fear a judgmental approach by their physician, who may try to discourage them. Lastly, the tattooist does not have either the training or the education to properly advise a customer about his/her condition. Therefore, it is important that any physician be able to provide adequate counselling regarding the possibility of getting tattooed and under which conditions. Even though an exhaustive list is impossible to address, the main issues include chronic skin disorders, pigmented lesions of the skin, (congenital) heart disease, immunosuppressive diseases and treatments, blood clotting disorders, and pregnancy/breastfeeding.