Monkeypox is a global health emergency that is spreading across the world. Unlike previous outbreaks of monkeypox, which were zoonotically transmitted, cases of the current outbreak feature significant travel and sexual history.

A recent review of cases in Singapore highlights clinical clues to aid physicians narrow the broad differential diagnosis. Localised anogenital vesiculo-pustules are a common presentation in the current outbreak, and may occur unpredictably relative to other viral prodrome-like symptoms. Clinical vigilance and high index of suspicion can facilitate early detection to contain local transmission.