A retrospective audit of melanoma clinical diagnoses was undertaken for a group of 35 Australian dermatologists. This was compared with the histological diagnoses. In a 1-year period, 195 of the 686 clinically suspicious lesions were histologically confirmed as melanoma. Therefore, the number needed to treat for histological referrals for melanoma is four for this group of dermatologists. In addition, we found that the sensitivity for the diagnosis of melanoma was 89.1% if we consider all lesions that are possibly clinically suspicious of melanoma. Our results suggest that the clinical diagnosis of melanoma may not be difficult for lesions that are clinically characteristic.