Objective To compare the dermoscopy findings of rosacea and other skin diseases. Methods A total of 66 patients with suspected rosacea who visited the dermatology clinic of our hospital from January to December 2024 were selected as the research subjects. All patients underwent dermoscopy examination. Taking the clinical comprehensive diagnosis results as the gold standard, the sensitivity, specificity and accuracy of dermoscopy examination in the diagnosis of rosacea were analyzed, and the dermoscopic characteristics of rosacea and other skin diseases were compared. Results There was no significant difference in sensitivity, specificity and accuracy between dermoscopy examination and comprehensive diagnosis (P >0.05). Under dermoscopy, the proportions of light yellow and yellow-red background colors in rosacea lesions were lower than those in other skin diseases, while the proportions of red and dark red were higher than those in other skin diseases. The proportion of non-polygonal vascular patterns in rosacea was lower than that in other skin diseases, and the proportion of polygonal patterns was higher than that in other skin diseases (P <0.05). The proportion of irregular vascular arrangement in rosacea was lower than that in other skin diseases, and the proportion of regular arrangement was higher than that in other skin diseases. The proportion of no scales in rosacea was higher than that in other skin diseases, and the proportion of scales was lower than that in other skin diseases (P <0.05). The proportion of rosacea lesions distributed in the mandibular region was higher than that in other skin diseases, and the proportions of pustules and perifollicular oily droplets were both higher than those in other skin diseases (P <0.05). Conclusion Dermoscopy technology does not show prominent differences in sensitivity, specificity, and accuracy. Rosacea has characteristic manifestations different from other skin diseases under dermoscopy, and dermoscopy has a high detection rate for this disease, which is worthy of clinical application.