Tattoos, piercing, and scari cation are now commonplace among adolescents and young adults. This rst clinical report from the American Academy of Pediatrics on voluntary body modi cation will review the methods used to perform the modi cations. Complications resulting from body modi cation methods, although not common, are discussed to provide the pediatrician with management information. Body modi cation will be contrasted with nonsuicidal self-injury. When available, information also is presented on societal perceptions of body modi cation.