A number of commercially available devices have been developed to help dermatologists distinguish benign pigmented lesions from malignant melanoma, but it is unclear if and how these technologies should be adopted into clinical practice. This review summarizes the reported diagnostic accuracies of these devices and compares them to clinical exam and dermoscopy. Screening devices appear to have the highest utility in patient populations with a high prevalence of melanoma. However, even in high-risk patients the diagnostic accuracy of evaluative devices is not clearly superior to dermatologists skilled with dermoscopy, potentially limiting their cost effectiveness. General practitioners not skilled with dermoscopy are likely to have larger improvements in diagnostic accuracy when using evaluative devices, however further investigation into the best way to employ them is needed.