A three year old girl was observed to have bluish marks on her back, arms and legs. The social services initiated an examination on the local hospital, but no conclusion regarding the marks was reached. The girl was institutionalized before a forensic examination after three days concluded that the marks were Mongolian spots. The case stresses the importance of being able to distinguish between Mongolian spots and skin hematomas and the need for a genuine clinical forensic examination in cases where child abuse is suspected. A guide for distinguishing between Mongolian spots and skin hematomas is presented.