Tumor necrosis-alpha (TNF-alpha) has been implicated in many forms of inflammation and is an end-stage product of the inflammatory cytokine cascade. It is an inducer of inflammation and is involved in many cutaneous and systemic inflammatory diseases. The development of agents that block the effects of TNF-alpha has aided in the treatment of many of these diseases. This article will briefly discuss the production, structure, and administration of the TNF-alpha inhibitors. There will be a focus on the mechanism of action of each of the TNF-alpha inhibitors as well as their benefit in their FDA approved and non FDA approved dermatologic conditions. The side effect profile and monitoring recommendations for these agents will also be discussed.