The diagnosis of bullous pemphigoid is based on clinical observations and on the presence of autoantibodies directed against proteins of the dermoepidermal junction. Human recombinant BP180 and BP230 peptides have been used to develop new quantitative enzyme immunoassays (EIA) for the detection of specific antibodies. This study evaluated the sensitivity and specificity of a new immunoassay for the detection of BP230 autoantibodies and clinical correlations. Serum samples were tested from patients with bullous pemphigoid, other skin diseases, and from healthy donors. Autoantibodies anti-BP230 and anti-BP180 were assayed using the EIA method. Diagnostic specificity for both tests was over 98%; diagnostic sensitivity was 90% and 60% for anti-BP180 and anti-BP230, respectively. IgG anti-BP180 titers exhibited a significant correlation with disease activity. No patient in remission was positive for anti-BP230. In conclusion, anti-BP180 and anti-BP230 assays are useful in the diagnosis of bullous pemphigoid and provide information on disease activity.