High resolution ultrasonography, using 20-50 MHz transducers, is a novel diagnostic procedure for the investigation of the skin and its specific conditions. Conventional ultrasonongraphy allows the identification of palpable pigmentary lesions without being able to establish the histologic type of the lesions. The method assesses the degree of tumoral penetration and the presence, type and intensity of circulation at that level. High resolution ultrasonography allows the identification of macular and nodular pigmentary lesions located up to 1.5 cm in depth. There is a correlation between the high resolution ultrasonographic aspect and the Breslow index used for melanoma stadialization. This correlation is limited in the presence of perilesional inflammatory infiltrate. The imaging examination is a valuable assessment method of the skin and its specific conditions. High frequency cutaneous ultrasonography has an important contribution in the screening of pigmentary lesions at risk.