A pregnant 33-year-old woman with gestational diabetes presented to the dermatology clinic at 35 weeks’ gestation with redness on both palms. She reported no pain, pruritus, or rashes elsewhere. The skin changes had first appeared during the second trimester of pregnancy and had not abated after a course of topical glucocorticoids. Skin examination was notable for mottled, blanching erythema across the palms and fingers of both hands. A diagnosis of palmar erythema of pregnancy was made. Palmar erythema of pregnancy is one of the physiologic vascular skin changes of pregnancy. The erythema may be diffuse and blotchy — as in this case — or may be limited to the hypothenar or thenar eminences. In some cases, the redness is associated with itching, tingling, or burning. No specific treatment is indicated for palmar erythema of pregnancy, and the condition typically resolves within 2 weeks after parturition, although full resolution may take up to 2 months. One week after the patient’s early-term spontaneous vaginal delivery, the erythema had decreased substantially, and by 2 months after childbirth, it had resolved completely.