Medical photography can be both challenging and rewarding, particularly when faced with less than ideal situations and under pressure of time, environment and clinicians’ expectations. Clinical photographs are a scientific record, therefore, they should be accurately focused, exposed and framed. They should fulfil the brief and illustrate the subject effectively. The authors describe a photography technique that has been invaluable in the documentation and diagnosis of a rare clinical condition, (multicystic peritoneal mesothelioma) and in informing fellow clinicians of the visual appearance of disease.