Purpose: The aim of our study was to evaluate the potential of real-time spatial compound imaging (RTSCI) in dermatology. Materials and methods: An ATL 5000 SonoCT equipped with compact linear 15-7 MHz and linear 12-5 MHz transducers was obtained for skin visualization in a group of dermatological patients with various skin diseases. Results: Thirty-four people participated: 21 patients with various skin diseases and 13 persons with normal skin. The mean age was 43.4 years. For many diseases, RTSCI gave useful information about the lesional structure, thickness and relationship with surrounding structures. Conclusion: RTSCI allows objective, accurate, noninvasive and easy measurements of several parameters of skin morphology. It is useful in clinical trials, for evaluation of the effects of therapy, for preoperative evaluation of dermatological lesions, and enables visualization of subclinical and deep lesions, giving physicians the possibility of starting treatment before disease intensity increases. However, even such highly advanced ultrasound cannot completely substitute the clinical dermatological approach and the occasional need for histological diagnosis. This new method may, however, become an important adjunct method for the study of skin lesions.