Digital imaging is an alternative to 35-mm Kodachromes and may be a useful tool to the physician. The purpose of this study was to compare the quality of digital images to 35-mm images and then compare the two methods based on the ability to make the correct diagnosis. Dermatology patients were photographed with both a digital camera and a 35-mm camera. Images from 22 patients were compared and graded on four criteria (sharpness of image, contrast, depth of field, and trueness of color). Diagnoses were then made from 30 pairs of images of different patients. In all graded areas the 35-mm images scored significantly higher. The correct diagnosis was made in 69.6% of the digital images compared to 77.3% of the 35-mm images, a difference that was not statistically significant. One may conclude that digital images hold promise for present and future use in dermatology and other areas of medicine.