BackgroundWhen used correctly, dermoscopy is an essential tool for helping clini-cians in the diagnosis of skin diseases and the early detection of skin cancers.Despite its proven benefits, there is a lack of data about how European dermatol-ogists use dermoscopy in everyday practice.ObjectivesTo identify the motivations, obstacles and modifiable factors influencingthe use of dermoscopy in daily dermatology practice across Europe.MethodsAll registered dermatologists in 32 European countries were invited tocomplete an online survey of 20 questions regarding demographic and practicecharacteristics, dermoscopy training and self-confidence in dermoscopic skills,patterns of dermoscopy use, reasons for not using dermoscopy and attitudesrelating to dermoscopy utility.ResultsWe collected 7480 valid answers, of which 89% reported use of der-moscopy. The main reasons for not using dermoscopy were lack of equipment(58% of nonusers) and lack of training (42%). Dermoscopy training during resi-dency was reported by 41% of dermoscopy users and by 12% of nonusers(P<0001). Dermatologists working in public hospitals were the least likely touse dermoscopy. High use of dermoscopy across the spectrum of skin diseaseswas reported by 62% of dermoscopy users and was associated with dermoscopytraining during residency, the use of polarized light and digital dermoscopydevices, longer dermoscopy practice, younger age and female gender.ConclusionsExpanding access to dermoscopy equipment, especially in publichealthcare facilities and establishing dermoscopy training during dermatology res-idency would further enhance the substantially high dermoscopy use across Euro-pean countries.What’s already known about this topic?•Dermoscopy is a well-established tool for the noninvasive diagnosis of skin diseases.•The benefits of dermoscopy depend on correct use by trained physicians.•Although considered to be widely used in Europe, reports on dermoscopy use bydermatologists have been carried out in only two European countries so far.What does this study add?•Our study is the first pan-European survey of dermatologists regarding the patternsof use, training and attitudes towards dermoscopy.