To examine the nature and psychosocial correlates of skin-picking behavior in youth with Prader-Willi Syndrome (PWS). Parents of 67 youth (aged 5–19 years) with PWS were recruited to complete an internet-based survey that included measures of: skin-picking behaviors, the automatic and/or focused nature of skin-picking, severity of skin-picking symptoms, anxiety symptoms, developmental functioning, symptoms of inattention, impulsivity, and oppositionality, and quality of life. Results indicated that skin-picking was endorsed in 95.5% of youth. Direct associations of moderate strength were found between skin-picking severity and symptoms of anxiety, inattention, oppositionality, developmental functioning, and quality of life. Other descriptive data, such as areas picked, cutaneous factors, antecedents, and consequences related to skin-picking are reported. The prevalence and consequences associated with skin-picking in PWS indicate a greater need for clinician awareness of the behavior and interventions tailored to meet the needs of this population.