BACKGROUND Although dermatoscopy is widely used in Europe and Australia, little is known about dermatoscopy use by US dermatologists. OBJECTIVE We sought to estimate the prevalence of dermatoscopy use by US dermatologists and examine associations with practice characteristics. METHODS We conducted a cross-sectional survey of all US fellows of the American Academy of Dermatology. RESULTS Of 8501 eligible recipients, 3238 (38.1%) surveys were completed and returned. Of respondents, 48% used dermatoscopy (n = 1555). Dermatoscopy use was associated with the following characteristics: age younger than 50 years (P < .0001), female sex (P = .0001), practice location in the Northeast (P < .0001), involvement in resident teaching (P < .0001), and dermatoscopy training (P < .0001). The main reasons for not using dermatoscopy included: lack of training (39.7%), lack of interest (32.5%), time required for dermatoscopic examination (27.6%), and belief dermatoscopy would not affect clinical decisions (15.2%). CONCLUSIONS Low response rate and potential response bias were limitations. CONCLUSIONS Approximately half of respondents used dermatoscopy in their practice. Not surprisingly, dermatoscopy users were more likely to be younger, involved in resident teaching, or have training in dermatoscopy.