Abstract: Objective To analyse and explore the observation and diagnostic application value of morphea-like basal cell carcinoma using dermatoscopy and reflectance confocal microscopy (RCM) in clinical practice. Methods Sixteen patients with morphea-like basal cell carcinoma who presented to our hospital from January 2018 to May 2025 were selected. First, a clinical diagnosis is made by an experienced dermatologist; subsequently, dermoscopy and RCM were performed by a dermato-imaging physician. Finally, the diagnostic results were compared with histopathological examinations, and retrospective analyses were conducted. Results Dermoscopy showed blue-black small spheres, branching, and serpentine capillary dilatation in 13 patients;areas of high brightness,milky structureless were observed in 10 patients; and millet-like cysts along with pepper powder-like structures were noted in 3 patients. In this group of 16 patients, RCM and histopathology showed epidermal atrophy,while the dermis showed multiple tumours consisting of cord-like and nested basal cell masses, accompanied by dense, sclerotic peritumoral stroma. Contraction spaces were also observed in some tumor masses. Conclusions In this paper,dermoscopy and RCM, as non-invasive examination techniques, were applied to summarise and analyze the skin lesions of patients with morphea-like basal cell carcinoma, providing reliable clues for clinical diagnosis.