The presence of vesicular or pustular lesion in the neonatal period evokes justifiable concern in a clinician caring for this vulnerable population. Both life-threatening bacterial and viral infections may present in this fashion. We present a white male neonate who was diagnosed as transient neonatal pustular melanosis. It is important to differentiate this type of benign and transient dermatosis from life-threatening pyoderma, because its recognition may spare the healthy neonate from extensive sepsis work-up, antibiotic therapy, and prolonged hospitalisation.