Melanoma is a common malignant tumor that can originate in the brain or in organs and tissues outside of the brain and eventually metastasize to the brain. Melanoma is highly malignant, insensitive to common radiotherapy treatments, and has poor overall treatment outcomes. With the advancement and development of targeted therapies and immunotherapy, melanoma treatment has ushered in new hope and many melanoma patients have significantly longer survival time. However, when melanoma metastases to the brain, it will rapidly produce an increase in intracranial pressure and threaten the patient’s life. Timely and effective treatment of melanoma brain metastases is an important factor in prolonging the survival time of melanoma patients. Since most anti-tumor drugs have difficulty reaching the brain, melanoma often metastasizes to the brain during drug treatment. Depending on the size and number of melanoma metastases to the brain, etc., melanoma metastases to the brain require flexible and different treatment options. Although melanoma is not particularly sensitive to radiotherapy, radiotherapy can achieve some control for smaller metastatic melanoma in the brain that is not sensitive to drug therapy; however, most melanomas that metastasize to the brain need to be If the number of metastatic lesions is relatively small and can be removed at once, the treatment effect is relatively good. When conservative treatment methods such as drug replacement and radiation therapy are ineffective, surgical resection is an effective treatment for large metastatic melanoma, especially for a single metastatic melanoma in the brain, which can rapidly reduce intracranial pressure and relieve neurological compression. Further genetic testing of tumor specimens can also help to develop a more effective treatment plan.