Dermatosurgery has been gaining in importance in recent years. In departments of dermatology German-speaking countries the total number of operations increased by 58% from 1984 to 1991. The increase in the number of operations of moderate and extreme severity was especially marked. Out-patient dermatosurgery was also performed mainly by dermatologists as opposed to other specialties. From 1988 to 1992 dermatologists in private practice recorded an increase of 40.6% in the number of operative procedures they performed. The importance of dermatosurgery in hospital and private practice can be expected to continue increasing in the future; dermatologists must therefore prepare themselves for the present and future challenges inherent in surgery of the skin.