The incidence of melanoma is on the rise, and early detection of disease is imperative to reduce mortality. Dermatologists are key players in the early detection of melanoma; however, some clinicians rely on their clinical examination without any additional diagnostic tools to make this important diagnosis. Certain patients, such as atypical nevus patients, have more complicated mole examinations, making the diagnosis of melanoma difficult, whereas some melanomas, such as amelanotic melanomas, can be diagnostically challenging. The goal of the clinician is to detect melanoma with the highest accuracy, while avoiding unnecessary biopsies. Using diagnostic melanoma tools as an adjunct to the clinical examination, dermatologists have the opportunity to increase both their sensitivity and specificity for melanoma detection. This article will review current imaging technologies and those in development for pigmented lesions, updating the clinician on basic principals of such modalities and clinical use of such technologies in practice.