Objective: Different dermatoscopic scores of pigmented skin lesions have provided a valuable tool in daily routine practice to differentiate malignant from benign lesions. However, these semiquatitative methods have a high rate of false positives in Spitz/Reed nevi. We have compared semiquantitative histopathologic and dermatoscopic findings in a series of Spitz/Reed nevi. Method: We collected 19 cases (15 female and 4 men) of atypical Spitz and/or Reed nevi. All cases were microscopically confirmed. A histologic index (HI) was constructed scoring the following findings: symmetry, sharp demarcation, architectural dysplasia, melanocytic atipia and nest size, and compared with validated dermatoscopic scores (ABCD score, 7-point checklist and Menzies score). Distributions of these scores for the different dermatoscopic patterns were also analyzed. Results: Median age at presentation was 15 years (range 1 to 36). The HI varied from 0 to 5 points. We found a strong positive correlation between the HI and Menzies score (r=0,539, p=0,01). In addition, HI values differed significantly when the multicomponent dermatoscopic pattern group was compared with the other patterns (U =22, 5 Z =−2,25, p =0.01). Conclusion: Menzies is the only dermatoscopic score which strongly correlates with histologic findings in Spitz/Reed nevi and may be useful in the diagnosis of atypical lesions.