The genital examination is an essential yet frequently underperformed component of the total body skin exam, particularly in dermatologic practice. This chapter highlights the clinical importance of genital examinations in identifying cutaneous neoplasms, primary dermatoses, and cutaneous manifestations of systemic disease. We explore barriers to routine examination, including patient and provider discomfort, and offer strategies to standardize and enhance this practice in the dermatology setting. Key elements of successful genital examinations are detailed, including patient communication, proper room setup, patient positioning, and the use of trauma-informed and gender-affirming care principles. The chapter also reviews procedural considerations such as biopsies and anesthesia, with special considerations for pediatric and transgender populations. By adopting a systematic and inclusive approach, dermatologists can optimize diagnostic accuracy, patient trust, and resultant clinical outcomes.