Isotretinoin is an oral systemic retinoid indicated for severe acne or moderate acne not responsive to conventional therapy. In this session, Linda F. Stein Gold, MD discusses the recommendations for laboratory monitoring for patients taking isotretinoin and the data on which laboratory abnormalities may occur with isotretinoin. Further, she highlights the risk factors for relapse, particularly insufficient dosing. Dr. Stein Gold also discusses the benefit of taking isotretinoin with fatty food and presents data regarding the improved delivery of the drug. Additionally, Dr. Stein Gold examines the data regarding the risk of depression and inflammatory bowel disease for isotretinoin and provides pearls for clinicians for monitoring.