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Confocal microscopy enables the acquisition of non-invasive microscopic images with real-time visualization of nuclear and cellular morphologies in vivo, which is analogous to histological imaging at high magnification. Thus, this tool has become useful in the diagnosis of melanoma and non-melanoma cutaneous tumors. The resulting images are oriented parallel to the surface of the skin (transverse sections), which is the major difference compared to conventional histology. The fact that confocal microscopy images the tissue in the horizontal plane, similar to dermoscopy, and provides high magnification with a cellular resolution that is similar to that of histopathology, makes this technique an important area of clinical research in evaluating skin cancer. The objective of the article is to describe this technique and its primary diagnostic findings for different types of skin cancer.