Europe comprises a diverse group of sovereign nations, with a wide range of health service organizations in the public and private sectors. European authors have made a significant contribution to the evidence base for Mohs micrographic surgeryMohs micrographic surgery (MMS) and to the debate about margin control in skin cancerSkin cancer surgery. MMS has been an important influence in the development of dermatological surgery as a subspecialty of dermatology, in many European countries. The continued development of MMS in Europe is likely to depend on a well-trained body of practitioners committed to excellence in treatmentTreatment outcomes for patients with skin cancerSkin cancer, high-quality audit, outcome, cost analysis, and clinical research. MMS in Europe is likely to continue to flourish despite the challenges that exist.