Lentigo maligna (LM) is well known as an irregularly pigmented macular lesion usually presenting on the sun-damaged head and neck of older patients. Lentigo maligna (LM) has the potential to develop into invasive melanoma (LMM). A method of surgical excision for the treatment of LM and LMM using paraffin sections with tissue mapping to ensure clear margins before delayed defect closure is described. The results of applying this method in the treatment of 66 cases over a 40 month period are presented. Thirty-eight per cent of cases required two excisions or more to clear the tumour and 32% of cases showed evidence of invasive melanoma. Only one case has recurred thus far, and none have developed metastatic disease.