The use of vital blue dyes in sentinel lymph node mapping and biopsy is gaining popularity in the surgical management of cancer. However, intraoperative use of these dyes has associated risks for the patient. This case report and review of the literature present current medical knowledge about one of the vital blue dyes, isosulfan blue, and the associated clinical risks of this dye when used in the perioperative management of patients who undergo sentinel lymph node mapping and biopsy.