Purpose: Precise and lasting preoperative marking of surgical reference points and incisions is crucial in Plastic and Reconstructive Surgery. These markings need to endure rigorous surgical skin preparation. Increasingly, alcohol based skin preparation is being employed due to evidence demonstrating superiority at preventing surgical site infections. Unfortunately, alcohol is a solvent for the gentian violet dye that is often used on surgical marking pens. Methodology: We performed a study comparing ten markers available in Australia: six gentian violet surgical markers, one patented “prep-resistant” XL surgical marker and three commercially available black permanent markers. Three volunteers' thighs were marked with each pen and the skin was washed with a pink tinted 0.5% chlorhexidine gluconate (w/v) with 70% isopropyl alcohol (v/v) solution. The number of passes needed for markings to fade was measured and visibility was assessed blindly by two assessors. Results: At least four passes with the preparation sponge were required before skin markings began to fade. Gentian violet surgical markers performed poorly and were least resistant to alcohol-based preparations. The “prep-resistant” Viscot XL marker was significantly more visible that gentian violet markers, however these markings were less visible than all permanent markers. Of the permanent markers tested, the Pentel N50 marker was the best performing followed by the Sharpie Pro marker. Conclusion: The Pentel N50 permanent marker provided the most durable markings after skin preparation. While there is evidence demonstrating negligible risk of bacterial transfer, “prep-resistant” Viscot XL marker is an option where single-use sterile markers are desired.