Skin substitutes have an important role in plastic and reconstructive surgery with a wide range of available products and applications. An up-to-date understanding and appreciation for their unique advantages and disadvantages is essential for any reconstructive surgeon to provide individualised and informed care. The ideal skin substitute may be described with the following characteristics: inexpensive, long shelf life, applicable off the shelf, non-antigenic, durable, flexible, prevent dehydration and withstand hypoxia, pathogenic barrier, easy to contour, easily secured, expands with growth in children, single-stage application, avoids hypertrophic scars. Temporary substitutes include biologic agents such as allografts, xenografts and amnion, and synthetic products include silicone- and silver-based dressings. Permanent skin substitutes aim to replace either dermal or epidermal components of skin. Epidermal substitutes include cultured epithelial autografts and autologous non-cultured cell therapy. Dermal substitutes include various acellular dermal scaffolds, often utilising both biologic and synthetic components, or fully synthetic dermal substitutes which are growing in popularity. Finally, recent innovations in tissue engineering have included the development of composite or full-thickness skin substitutes which, though not yet evidenced in randomised controlled trials, show promise for ongoing advancement toward the ideal skin substitute. This presentation will provide an up-to-date overview of the available skin substitutes, discuss their benefits, limitations and applications to the field of plastic and reconstructive surgery.