Fourteen cases of basal cell carcinoma occurring in North American black patients were reviewed. The majority of the lesions were asymptomatic, hyperpigmented, translucent nodules and were correctly diagnosed as being basal cell carcinomas prior to biopsy. All of the lesions except one arose in the sun-exposed areas of the head and neck, indicating that basal cell carcinoma in blacks, as in whites, is related to exposure to ultraviolet light. Microscopic examination revealed changes characteristic of basal cell carcinoma. The response to therapy in our patients was good. There appear to be no histologic or clinical differences in the basal cell carcinomas that arise in black and white patients.