Between 1981 and 1983, 329 patients with cutaneous melanoma registered in Amsterdam and Rotterdam, The Netherlands, were analysed with respect to the referral pattern and accuracy of clinical diagnosis. With increasing Breslow thickness, a greater proportion of the patients were referred to the surgeon than to the dermatologist (p < 0.01). The overall clinical suspicion rate was 61.6%. Suspicion of melanoma was greater for lesions .ltoreq. 2 mm thick vis-a-vis the > 2 mm thickness group (p < 0.01). Accuracy of clinical diagnosis was better for dermatologists than for surgeons (p < 0.01, after adjustment for microstage). Differential diagnoses were more often considered by dermatologists than by surgeons (p < 0.01). Vague descriptions such as ''tumour'' without specification were less frequently used by dermatologists than by surgeons (p < 0.01). Amelanotic melanomas were often missed clinically by both disciplines (overall diagnostic accuracy 28.6%). It is emphasized that close cooperation between dermatologists and surgeons in the clinical management of melanoma is highly desirable.