Reflectance confocal microscopy is a modern, non-invasive diagnostic method that enables real-time imaging of the epidermis and upper layers of the dermis with nearly histological precision and high contrast. The application of this technology to skin imaging during the last years has resulted in progress of dermatological diagnosis, providing virtual access to living skin, without the need for conventional histopathology. The presented method potentially has broad application in the diagnosis of skin diseases. This article provides a summary of the latest reports and previous achievements in the field of reflectance confocal microscopy. General characteristics of confocal images in selected inflammatory skin diseases are presented.