Electrochemotherapy represents a new innovative technology using a combination of electroporation and application of very low dose cytotoxic drugs for the treatment of cutaneous and subcutaneous skin tumors and metastases. Based on a high number of preclinical and clinical studies this procedure has been established as a simple, safe and very effective tumor treatment whose costs are acceptable. The procedure can be performed as a single treatment of localized disease as well as a repeated palliative treatment of cutaneous metastases regardless of the tumor type. Because of the lack of significant side effects and of short duration the procedure can be performed on an out-patient basis. Several studies led to the validation of standard operating procedures for its use in daily clinical practice. This treatment has become established in many different European countries.