Livedo reticularis (LR) is a chronic, painful, thrombo-occlusive cutaneous vasculopathy that affects the distal lower extremities and feet. LR manifests as a characterized hyperpigmented color change, either temporary or permanent, with a mottled, reddish-blue to purple, intact circular or net-like structure. LR is a benign, primary condition that predominantly affects young to middle-aged women. LR typically presents on the legs when exposed to cold and gradually resolves with warmth. Primary complaints include coldness, numbness, and pain, with aesthetic concerns being prominent in all patients. In addition to suggestive physical findings for diagnosis, a biopsy may be necessary.