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While there has been a notable increase in conversation about race and racism in the psychoanalytic literature, skin tone and colorism have received less attention. For patients who have Indian heritage, lighter and darker skin tones can have multiple meanings in various contexts, including within the family, the Indian ethnic community, the social communities they interact with, and the larger sociopolitical context of the United States in which White and lighter skin is idealized and privileged. Exploring skin tone fantasies in psychotherapy can be a meaningful intervention to address racial and ethnic identity development, intrapsychic conflicts, interpersonal dynamics, and racial and skin tone trauma (Landor & McNeil Smith, 2019; Tummala-Narra, 2007). Skin tone biases and colorism within the Indian diaspora and in the United States are addressed within a historical, sociocultural context. Psychoanalytic ideas are discussed to understand the complex meanings, feeling states, enactments, and defenses that skin tone and colorism can raise for the patient and therapist who have shared Indian heritage.