Pressure injury and incontinence-associated dermatitis are common pelvic skin injuries. Skin assessment of the pelvic region is complex and must consider multiple factors. Pressure injury and incontinenceassociated dermatitis are often misclassified, leading to inappropriate prevention and treatment strategies being implemented. This may result in poor clinical outcomes and suboptimal use of healthcare resources. This paper reports the results of an expert working party consensus process to produce a practical guide to support systematic skin assessment of the pelvic region in adults. It also provides information supporting the accurate differentiation between these commonly misclassified skin injuries.