<b><i>Objective:</i></b> To evaluate organizational structure and diagnostic procedures used by the Italian hospital network for identifying cutaneous melanoma. <b><i>Methods:</i></b> A nationwide survey of a representative sample of centers was conducted. <b><i>Results:</i></b> Diagnosis occurs mainly in ambulatory dermatology clinics (91%). In all high-volume hospitals, clinical and dermoscopic examination is available at first consultation or as an additional service, compared to 89% of low-volume hospitals. Computer-assisted videodermoscopy is available in 75% of hospitals, with a statistically significant difference between high- and low-volume hospitals (86 vs. 62%; p < 0.001). First consultation is generally an integrated clinical/dermoscopic evaluation (55% of high-volume centers vs. 47% of low-volume hospitals); digital evaluation is available for monitoring suspicious lesions and high-risk patients in 25% of high-volume centers versus 19% of low-volume centers. <b><i>Conclusions:</i></b> The organizational structure and diagnostic procedures in Italian hospitals are in line with modern diagnostic procedures for early diagnosis of melanoma. Dermatologists have a central role in managing diagnosis of primitive melanoma.