In view of the increasing interest in epiluminescence microscopy (ELM) and its newer computer-assisted variants to evaluate pigmented lesions, it is timely to ask "What is the most important purpose of the procedure?" The conventional answer, illustrated by the 2 articles on the subject in the December 1999 issue of the ARCHIVES,1,2 is to improve the ability to diagnose melanoma. I suggest the primary purpose should more simply be to determine whether a lesion needs to undergo a biopsy procedure.