Bosentan, a dual-endothelin receptor antagonist, has emerged as a valuable therapeutic option in dermatology, despite its primary approval for pulmonary arterial hypertension. Bosentan has diverse applications in dermatological conditions, particularly its role in managing digital ulcers, non-digital ulcers, Raynaud’s phenomenon, and skin fibrosis in scleroderma patients are quite useful. The drug has shown promising results in preventing and treating digital ulcers, with variable efficacy in Raynaud’s phenomenon and skin fibrosis. Limited evidence suggests potential benefits of bosentan in dermatomyositis-associated ulcers and port wine stains.