In Latin American populations, acral lentiginous melanoma is the prevailing type of melanoma. Its relationship to preexistent benign volar melanocytic lesions has not been established; however, it is common practice to remove these lesions from children in spite of the fact that childhood acral lentiginous melanoma is extremely rare. To determine the frequency and the clinical and dermatoscopic characteristics of acrally located pigmented melanocytic lesions in schoolchildren of Manizales, Colombia, we undertook an exploratory, descriptive study of 1106 schoolchildren in search of pigmented volar and ungual lesions. In the study group there were 680 males and 426 females, ranging in age from 6 to 23 years (median age 13 years). At least one acral pigmented lesion was found in 464 individuals (42%). Their distribution over the volar surface was rather regular. Increasing age and darkness of the skin correlated with an increased number of lesions. Dermatoscopic patterns were consistent and suggestive of union nevus and simple lentigo as the predominant types of melanocytic proliferation. Typical pigmented melanocytic volar skin lesions are very common in our schoolchildren. Removal of these lesions is not routinely recommended since a relationship with acral lentiginous melanoma has not been established.