Lentigo maligna is an in situ melanoma which usually affects sun-damaged skin on the head and neck. In patients with lentigo maligna, the clinically visible demarcation often correlates poorly with the histopathologically confirmed demarcation. The standard treatment for lentigo maligna is excision with at least 5 mm margins. The key disadvantage of regular excision is the lack of histological margin control, resulting in non-radical excisions and a higher risk of recurrence. Micrographic surgery is indicated for patients with lentigo maligna because this technique is tissue-sparing and it offers absolute certainty concerning the presence of clear histological margins.