A new case of infantile acropustulosis and a review of previous cases disclose an uncommon pustular dermatosis that occurs primarily in black male infants. This condition consists of intermittent and recurrent crops of intensely pruritic, 1- to 3-mm vesiculopustules that appear predominantly on distal extremities. The onset is from birth to 1 year of age, with spontaneous resolution occurring between the ages of 2 and 3 years. This eruption does not respond to routine therapies, and the only effective treatment has been dapsone. Because similar clinical features have been found in several other pediatric cutaneous diseases, we discuss the differential diagnosis.