Background: early node dissection offers increased survival in patients with node metastases only. The study of sentinel node (SN) using blue dye and radiolocalization permits to identify patients who could undergo lymphadenectomy. Methods: at Department of Surgery of Macerata General Hospital 22 patients with melanoma of trunk or limbs at I and II stage were submitted to SN biopsy. Results: SN was identified in all cases by combined approach. Dynamic lymphoscintigraphy permitted identification of SL when it was not the node nearest the tumor. Nodal metastases were found in 2 cases (9.1%) and the patients underwent regional lymphadenectomy. In 1 patient the SN was the only node with metastases. Both patients had high thickness melanomas. The measurement of radioactive exposition for operating room personnel and pathologist demonstrated that the technique is safe and without risks. Conclusions: biopsy of SN is effective for identification of occult nodal metastases from cutaneous melanoma. Combined technique allows to localize SN in 100% of cases. There is not radioexposition for operators