How to draw on a PDF on a Mac
Open the PDF in PDF Unlimited, switch to Annotate mode and pick the Pen tool, or press P while the page is active. Draw with your trackpad or mouse. For neat shapes, use Rectangle, Ellipse, Line or Arrow. Change color and stroke in the inspector, and press ⌘Z if a line goes wrong.
With PDF Unlimited (free)
Switch to Annotate mode
Open the PDF and click Annotate in the toolbar mode switcher.
Pick the pen
Choose the Pen tool, or press P on the page. It is also under Tools > Annotate > Pen.
Set color and thickness
Choose a color and stroke width in the inspector on the right. If the inspector is hidden, choose View > Show Inspector.
Draw
Drag across the page with the trackpad or mouse. Each stroke is its own annotation, so you can select it later to move or delete it.
Add clean shapes
For tidy marks, use Rectangle (R), Ellipse (O), Line (L) or Arrow (A). Drag to draw, then drag the handles to adjust.
Save
Save the file. To make drawings part of the page so nobody can edit them, use File > Export Flattened…
With Preview, built into macOS
Show the Markup toolbar
Open the PDF in Preview and click the Show Markup Toolbar button.
Use Sketch
Click Sketch and draw a single stroke. If Preview recognizes a standard shape, it swaps in a neat version; choose your original from the palette to keep the freehand line.
Use Draw, if you have it
Macs with a Force Touch trackpad also get a Draw tool, where pressing harder makes a heavier, darker line.
Style it
Use Shape Style for line thickness, Border Color for the line color and Fill Color for the inside of a shape.
Freehand or shapes
Freehand is great for circling a figure, scribbling a quick note in the margin, or sketching a rough layout over a floor plan. It is less great for anything that needs to look tidy. A trackpad circle drawn in one go tends to look like a potato.
That is what the shape tools are for. An ellipse around a number, an arrow pointing at a clause, a rectangle around a section of a diagram: all of them stay crisp at any zoom, and you can resize them afterwards. A good rule is pen for thinking out loud and shapes for anything someone else will read.
Drawing with a trackpad, mouse or iPad
A trackpad works fine for short marks. Go slower than feels natural and you will get smoother lines. A mouse is better for long, straight-ish strokes.
If you own an iPad and an Apple Pencil, Sidecar can extend your Mac display to the iPad, and some people find drawing that way much more natural. Either way, the drawings are ordinary annotations in the PDF.
Editable or flattened
Drawings are saved as annotations that sit on top of the page. That means you, or the next person, can select them, move them, recolor them or delete them. For review copies, that is what you want.
For a final version, you may want the opposite. File > Export Flattened… in PDF Unlimited saves a copy where drawings, highlights and form entries are part of the page itself. Apple suggests File > Print > Save as PDF for the same result in Preview. Read more in how to flatten a PDF.
Related markup
Drawing is one part of marking up a document. For highlights, underlines and sticky notes, see how to annotate a PDF. To type words onto the page, see add text to a PDF. And if a line you drew is meant to hide something, stop: a black shape is not a redaction. Use true redaction, which removes the content underneath.
Questions
How do I draw on a PDF on a Mac for free?
In PDF Unlimited, switch to Annotate mode and pick the Pen tool. In Preview, show the Markup toolbar and use Sketch, or Draw on a Mac with a Force Touch trackpad.
Why don't I see the Draw tool in Preview?
Apple says the Draw tool appears only on Macs with a Force Touch trackpad. Sketch is available on every Mac.
How do I draw a straight line or arrow on a PDF?
Use the Line (L) or Arrow (A) tool in PDF Unlimited's Annotate mode. Preview has lines and arrows under its Shapes button.
Can I erase part of a drawing?
Each stroke is a separate annotation. Select it and press Delete, or press ⌘Z straight after drawing to undo it.
Will my drawings show up for other people?
Yes. Annotations are saved inside the PDF and appear in other PDF apps. Flatten the file if you want them fixed in place.