Elastophagocytosis is the phagocytosis of elastic fibers that can microscopically be seen in the cytoplasm of histiocytes, multinucleated giant cells, or both. Generally believed to be a characteristic feature of certain granulomatous disorders such as annular elastolytic giant cell granuloma or elastolytic disorders such as mid-dermal elastolysis, this feature has also been described in other cutaneous inflammatory conditions, cutaneous malignancies, infectious entities, and secondary to certain medications. The list of diseases that can exhibit this peculiar finding on histopathology is long. In this review we attempt to shed light on the available literature concerning the pathogenesis of this phenomenon and the plethora of skin conditions that exhibit elastophagocytosis.