The various cutaneous markers for Spina Bifida Occulta include; midline or paraspinal mass, capillary hemangioma (Port-wine stain), hairy patch, dermal sinus, polypoid lesions or rudimentary tail or caudal appendage, atretic meningocele, or “cigarette burn” sign, Nevi or hyper pigmentation, aplasia cutis congenita, dyschromic lesions (hypopigmented macule, hyperpigmented macule, cafe´ au lait macule and mongolian spot), and deviated natal cleft. These signs might occur anywhere along the midline but are seen most frequently in the lumbar region. A combination of 2 or more congenital midline skin lesions is more reliable marker of OSD 1).