Labial melanotic macules (LMMs) are benign pigmented lesions that usually take the shape of flat asymmetrical macules with tan-brown to black color and variable size. Whereas the dermoscopic features of other pigmented skin lesions have been relatively well described, little is known about LMMs. To describe the dermoscopic features and find typical and schematic dermoscopic patterns in LMMs. A retrospective dermoscopic study was conducted on 80 lesions with histopathologically proved LMMs. We described and defined, for the first time to our knowledge, landscape painting patterns found in 65 of 80 melanotic lesions (81.3%), characterized by parallel lines or circle lines, overlapping vessels with background brown pigmentation. The background brown pigmentations were observed in 74 of 80 lesions (92.5%), the parallel lines in 62 (77.5%), the circle lines in 20 (25.0%), and overlapping vessels in 69 (86.3%). The structureless black pigmentations were only presented in 26 of 80 (32.5%). Dermoscopy can be useful for the clinical detection of LMMs, and "Landscape painting patterns" may represent a dermoscopic clue for the diagnosis of these lesions.