The clinical and pathological features of 29 cellular blue nevi (CBN) and one malignant cellular blue nevus from our hospital files were reviewed. Although the sacrococcygeal region/buttock was the commonest single site, the majority of CBN occurred on the limb peripheries. Two-thirds of patients were under the age of 40 years. Follow-up of a mean of 7 years did not reveal any evidence of malignancy. Four histological subtypes were recognized: mixed biphasic, alveolar, fascicular or neuronevoid, and atypical varieties. One case developed a benign nodal metastasis. In one case, malignancy arose within a CBN. The importance of recognizing the variety of patterns, the benign behavior of the atypical variety, and the criteria for malignancy are herein discussed.