Introduction: Keloids are benign, firm nodules resulting from excessive scar formation, typically following trauma, but they can also arise spontaneously. They commonly affect areas like the chest, shoulders, back, cheeks, and earlobes. Their growth exceeds the boundaries of the original injury. Keloids can cause discomfort, pruritus, or cosmetic concerns. While they are more prevalent in individuals with darker skin tones, they occur across all age groups and skin types. Differentiating keloids from conditions such as hypertrophic scars, dermatofibromas, acrochordons, inflamed nevi, cysts, and lipomas i s crucial for proper diagnosis and management. This review highlights the diverse clinical presentations of keloids across various Fitzpatrick skin types. Case Presentation: We present a series of cases demonstrating the diverse presentations of keloids across various Fitzpatrick skin types. The first case involves a 16-year-old male with Fitzpatrick skin type I, presenting with pink, shiny, raised keloids on the shoulders, back, and chest secondary to cystic acne. The second case shows a woman with Fitzpatrick II skin type, presenting with a biopsy-confirmed keloid, described as a firm, pink, linear, well-demarcated raised plaque without adnexal structures, resulting from a previous surgery. The third case features a 17-year-old male with Fitzpatrick III skin type, displaying shiny, pink-to-purple keloids and active cystic acne scars on his chest, shoulders, and back. The fourth case is a 64-year-old female with Fitzpatrick IV skin type, presenting with smooth, linear keloids on her chest resulting from bypass surgery. The fifth case involves a 55-year-old female with Fitzpatrick V skin type, exhibiting linear keloids on her back and smaller plaques on her arm, all darker than her baseline skin tone. The final case is a 73-year-old male with Fitzpatrick VI skin type, who developed spontaneous, hyperpigmented linear keloids across his shoulders, arms, and back. Learning Points: Keloids present differently across Fitzpatrick skin types, often appearing pink or reddish in lighter tones and hyperpigmented in darker tones, highlighting the importance of recognizing these variations for accurate diagnosis. Despite these differences, keloids share common features, including smooth, firm nodules that extend beyond the initial trauma and lack adnexal structures, which help differentiate them from other common conditions such as hypertrophic scars, dermatofibromas, acrochordons, inflamed nevi, cysts, and lipomas. Effective diagnosis and management depend on understanding these variations and employing targeted interventions such as intralesional steroids or surgical excision.