Managing atopic dermatitis (AD) in patients with skin of color presents unique challenges for the clinician. There is increasing evidence that atopic dermatitis has higher prevalence, persistence, and severity among skin of color populations. This is likely to be partly related to differences in living conditions and exposure to irritants and allergens, among other factors. Assessment of AD severity in patients with darker skin can be challenging, in particular the assessment of erythema, leading to the potential for underscoring AD severity. Variations in disease have also been described, with the potential for a greater risk of inflammation-induced nodularity and hyper- or hypopigmentation. Management challenges include variable adherence to treatment, potential disparities in access to healthcare, and differences in the metabolism of cyclosporine. Optimal management of atopic dermatitis in patients with skin of color requires a tailored approach. Here we review approaches to diagnosing AD, evaluating extent and severity with subjective and objective measures, treatment options for patients with skin of color, and highlight areas for improvement in AD care for skin of color populations.