Objective To explore the application value of dermoscopy and reflective confocal microscopy (RCM) in the diagnosis of basal cell carcinoma (BCC). Methods A total of 50 patients who were diagnosed as BCC in the Department of Dermatology, Xuzhou Municipal Hospital Affiliated to Xuzhou Medical University were selected as the research objects. All patients were diagnosed by dermoscopy and RCM, and then confirmed by histopathological examination. The diagnostic effect was observed.Results The diagnostic sensitivity, specificity and coincidence rate of the combined detection method were higher than those of the single application of dermoscopy and RCM detection, the diagnostic coincidence rate of dermoscopy was lower than that of the combined detection, and the diagnostic coincidence rate of RCM was lower than that of the combined detection, the difference was statistically significant (P<0.05). Conclusion BCC has relatively specific dermoscopy and RCM features. Dermatoscopy combined with RCM has high sensitivity, specificity and accuracy in the diagnosis of BCC, and has high application value in the diagnosis of BCC.