Introduction: The pathognomonic trichodystrohy in Netherton's syndromeis trichorrhexis invaginata. This hair shaft anomaly is not constantly presentand it can be associated with other anomalies like trichorrhexis nodosa orpili torti.Methods: We retrospectively analyzed hair samples from patients diagnosedwith NS over the past 10 years in the Dermatology Clinic Timisoaraby using scanning electron microscopy. The samples were of scalp hair,eyebrows, eyelashes and pubic hair. We also evaluated some of these sampleswith trichoscopy and confocal microscopy.Results: The scanning electron microscopy results showed that trichorrhexisinvaginata was evident in all cases, followed by trichorrhexis nodosa andpili torti respectively. In these patients there was more than one type oftrichodystrophy present at the same time. All of these modifications wereperceptible with the confocal scanning microscope and by trichoscopy.Discussion: The electron microscopy helps by supplying three-dimensionalimages of the hair shaft, thus enabling the observation of the hair sampleswith a greater clarity and sharpness than through classical methods. Alsoreflectance confocal microscopy and trichoscopy have proven to be veryuseful in the diagnosis of hair shaft anomalies.