The derivation of a microscopic many-body theory for the nonlinear optical response of semiconductors is reviewed. At the Hartree-Fock level, the semiconductor Bloch equations include many-body effects via band gap and field renormalization. These equations are sufficient to describe excitonic resonances as they appear already in the linear absorption spectra. An adequate description of nonlinear optical effects in semiconductors beyond the Hartree-Fock level includes Coulomb interaction induced carrier correlations. Different schemes have been developed to treat such correlation effects. As two examples, the second-order Born approximation and the dynamics-controlled truncation scheme are introduced and analyzed. In addition to the derivation of the equations of motion, a few examples are presented which highlight important signatures of many-body correlations in the optical response of semiconductors.