Successful repigmentation was achieved in 6 patients with three types of hypomelanosis (vitiligo, piebaldism, and albinism) by transplantation of fresh, autologous cultured epithelium with melanocytes. A small piece of uninvolved skin was taken for cultivation from a site adjacent to the lesion. Epidermal cells were cultured according to Green's technique. The lesions were abraded superficially and autologous cultured epithelium was applied. The grafts with functional melanocytes took completely and the wounds healed with minimal scarring. Repigmentation was visible within 6 to 8 months. The skin color resembled the surrounding normal skin except in the albinistic patient, in whom the donor skin was taken from a hyperpigmented area. Histochemical examination revealed dopa-positive melanocytes 12 to 17 days after grafting in the basal layer of the epidermis and the dermis. These cells grew in the basal layer of the epidermis and the hair follicles. Melanistic granules were visible in the keratinocytes in 1.5 months. A normal number of dopa-positive melanocytes and melanistic granules were seen in approximately 8 months. Thus, the autologous cultured epithelial grafting procedure is a promising treatment for patients with hypomelanosis.