Purpose: Monkeypox is a viral cutaneous disease characterised by locally destructive skin lesions which predominate in cosmetically- and functionally sensitive areas. Its relatively low incidence and variable appearance result in frequent misdiagnosis as an infective or neoplastic process and subsequent incorrect management. Methodology: A literature review was conducted using the MEDLINE database, identifying 27 articles comprising a total of 1005 patients across 1 systematic review and meta-analysis, 3 cohort studies, 2 case series, 16 case reports, 2 review articles and 3 technical studies. We also present our experience with 2 cases of monkeypox at our institution. Results: Monkeypox lesions present with a characteristic umbilicated, pseudo-pustular morphology and macular-vesicular progression. They have a distinctive distribution centred on anogenital-oral sites of inoculation, with synchronous lesions that typically range from a few to 20 lesions. They occur disproportionately in high-risk subgroups, namely men who have sex with men, men with multiple partners, sexually transmitted disease co-infection including HIV and syphilis, and patients with recent travel to endemic areas. Optimal management comprises early detection, non-surgical management, antiviral therapy in severe cases and active scar management following clearance of infection. Conclusion: The increasing prevalence of monkeypox in Australia represents an emerging reconstructive and cosmetic challenge for plastic surgeons. Effective management requires early recognition and a high index of suspicion in high-risk populations.