Melasma is an acquired chronic pigmentary disorder occurring on sun-exposed areas. Was to differentiate dermoscopic features of melasma between treated and untreated and if there are any features to confirm ongoing ochronosis. This is descriptive cross-sectional study conducted in the Department of Dermatology in Al-Kindy teaching hospital from June 2021 to April 2022. Females of any age with melasma were included in study and then divided into those who were treated previously with topical steroid and hydroquinone for more than 6 months and non treated group, photos were taken for all by iPad 11 pro, and polarized DL4 dermlit dermoscopy connected to iPad 11 pro. A checklist features of dermoscopy for melasma and ochronosis were prepared and dermoscopic photos were taken for each patient. These photos were evaluated by 2 dermatologists independently to indicate which sign each patient has. Wood light examination was also done for each patient to indicate level of pigment whether epidermal, dermal and combined. Statistical analysis was conducted using Statistical Package for Social Sciences (SPSS) version 26. In this study, a total number of patients was 79 with a mean age 38.63 ± 6.3 years. Fifty-seven were treated previously with a mean age of 38.08 ± 5.9 years while untreated group only 19 patients with the mean age was 40.04 ± 7.1years. We noticed that the prevalence of pseudo articular, telangiectasia, perifollicular accentuation, annular or arcuate, Confetti like or dotted depigmentation, and curvilinear or wormlike were significantly higher (P < 0.05) in treated than untreated groups. The most common type of pigmentation by dermoscopy in the treated group was combined (50.9%); while epidermal type in untreated group (77.3%) which was statistically significant (P= 0.004), while dermal type of pigment was only obvious in only 7 (12.3%) of treated group. By wood lamp, epidermal type was 43.9% in treated group and 77.3% in untreated group, this difference was statistically significant. There was a significant agreement between dermoscopy and wood lamp. Telangiectasia, annular or arcuate pigmentation, dermal or dermo-epidermal level of pigmentation were mainly present in treated melasma and could be features of ongoing ochronosis in these patients.