Permanent makeup (PMU) is a popular form of tattooing used to replace or enhance the use of daily makeup. The purpose of this literature review is to provide an overview of PMU, with a particular focus on its use, regulation, and potential complications reported in the literature. In the United States, there is significant variation in the regulation and training required to perform PMU. Adverse outcomes of PMU include infectious, allergic, and inflammatory complications. These complications may be more common if proper hygiene and aftercare practices are not followed. Cosmetically, PMU may shift or have an altered appearance if the underlying skin is treated with cosmetic fillers or local anesthetics. Given the popularity of PMU and its cosmetic uses, dermatologists should be aware of the PMU industry, potential complications, and how best to manage complications.