Abstract: WANG Lei *, XU Ai-e. *Affiliated Hangzhou Clinical College, Anhui Medical University, Hangzhou 310009, China Corresponding author: XU Ai-e, Email: xuaiehz@msn.com 【Abstract】 Objective To assess the microscopic features of lentigo by using in vivo confocal laser scanning microscopy（CLSM）. Methods This study included 30 patients clinically diagnosed with solar lentigo and 10 patients with lentigo simplex. Lentigo lesions and perilesional normal skin were examined by in vivo CLSM. Tissue specimens were also obtained from lesional and perilesional normal skin and subjected to routine histopathologic examination. Results The CLSM features of lentigo were mainly observed at the dermo-epidermal junction. In all of these cases of lentigo, there was an increase in the length and number of rete ridges, with a marked hyperpigmentation of the basal layer. Several distinct microscopic patterns were observed, such as extended, irregularly shaped papillary dermis surrounded by highly refractile cells （presumed to be basal keratinocytes）. Histopathologically, there was an infiltrate of a small quantity of melanophages and lymphocytes in superficial dermis. Conclusion As far as lentigo lesions are concerned, CLSM images are consistent with histopathological findings.