BACKGROUND: There are no reported epidemiological data regarding autoimmune pemphigus in the Afro-Caribbean population. OBJECTIVES: To present the epidemiology of autoimmune pemphigus on the island of Guadeloupe (French West Indies, 400,736 inhabitants, mostly black Caribbean of African European descent). MATERIALS AND METHODS: Five-year prospective study. Inclusion of the incident cases when directly referred to the Dermatology Department or secondarily referred by their private practice dermatologist once identified by the computerized databases of the Guadeloupian pathology laboratories. RESULTS: World-population-standardized incidence was 6.96 (95% CI: 3.41-10.52) for pemphigus vulgaris and 3.75 (95% CI: 1.12-6.39) for pemphigus foliaceus. Patients usually live in the rural countryside, whereas 75% of the population of Guadeloupe Island live in an urban environment. CONCLUSION: We report a high incidence of autoimmune pemphigus in Guadeloupe, especially for the foliaceus type, and the existence of particular epidemiological features such as the rural countryside habitat.