Abstract Introduction: To present the use of digital spot mammography (DSM) in a diagnostic practice. Methods and patients: Digital spot images of 779 women requiring a spot compression or a spot magnification view were collected. The digital images were acquired on a digital spot upright unit using a 61 mm×61 mm field of view. Lesions reported included masses, calcifications, and areas of distortions. Results: 1065 lesions required additional views with DSM. Lesions reported included masses ( n=113), masses and microcalcifications ( n=53), spiculated masses ( n=34), architectural distortions ( n=16), and microcalcifications ( n=849). DSMs were considered to be adequate in 97.7% of patients. Unsatisfactory exams resulted from difficulties encountered in targeting the area of interest at the beginning of our experience. Conclusion: DSM, most commonly used to perform interventional procedures, can also be used in a diagnostic practice taking advantage of post-processing of images not available with conventional spot compression and magnification.