We report a case of amelanotic melanoma that was clinically and dermoscopically featureless; it was repeatedly missed during examination at a pigmented lesion clinic. Dermoscopy evidenced a peculiar vascular pattern, and only the adoption of a specific diagnostic algorithm including the atypical vascular pattern among the major diagnostic criteria would have helped the observer make the correct diagnosis. The risk of false-negative diagnosis by both clinical examination and dermoscopy during melanoma screening as well as the possible role of dermoscopy in the diagnosis of amelanotic melanoma are discussed. (J Am Acad Dermatol 2002;46:957-9.)