Melanoma, also known as malignant melanoma, is a type of malignant tumor that originates from melanocytes and is commonly found in the skin, as well as in the mucous membranes and the choroid of the eye. Melanoma is the most malignant type of skin tumor and is prone to distant metastasis. Early diagnosis and treatment are therefore particularly important, and the treatment methods include the following: 1) Surgical treatment 1) Extended excision: Extended excision of primary foci should be done as soon as possible after biopsy confirmation of early melanoma. The safety margin of extended resection is determined by the depth of tumor infiltration in the pathology report: ① when the thickness of the lesion is ≤1.0mm, the safety margin is 1cm; ② when the thickness is 1.01-2mm, the safety margin is 1-2cm; ③ when the thickness is >2mm, the safety margin is 2cm; ④ when the thickness is >4mm, the latest evidence-based medical evidence supports a safety margin of 2cm. 2）Sentinel lymph node Biopsy (SLNB): SLNB can be considered for patients with a thickness of 1 mm, but in view of the fact that the incidence of ulceration in cutaneous melanoma in China is more than 60% and the prognosis of cutaneous melanoma with ulceration is poor, SLNB is recommended for patients with combined ulceration when biopsy techniques or pathological detection techniques are limited so that a reliable depth of infiltration cannot be obtained. (3) Lymph node dissection: No Prophylactic lymph node dissection is not recommended. Patients with positive sentinel lymph nodes or regional lymph node metastasis judged by imaging and clinical examination (but stage III patients without distant metastasis) should undergo regional lymph node dissection on the basis of extended resection. (4) Management of limb metastasis:Limb metastasis is manifested as extensive metastasis of skin, subcutaneous and soft tissues between the primary foci of one limb and regional lymph nodes, which is difficult to be removed cleanly by surgery. This type is dominated internationally by isolated thermal perfusion chemotherapy (ILP) and isolated thermal infusion chemotherapy (ILI), which is an anaerobic, low-flow infusion of chemotherapeutic agents as a local treatment, and the infusion of melphalan through an interventional arteriovenous cannula to establish chemotherapy access. (5) Stage IV patients who show isolated metastases can also be considered for surgical resection. 2. Adjuvant treatment of cutaneous melanoma The prognosis of postoperative patients varies according to risk factors. According to risk factors such as depth of lesion infiltration, presence of ulceration, and lymph node metastasis, postoperative patients are generally classified into four categories: ① stage IA (low risk); ② stage IB~IIA (intermediate risk); ③ stage IIB~IIIA (high risk); ④ stage IIIB~IV (very high risk). Low-risk patients have the potential for long-term survival, with a 5-year survival rate of about 95%. Intermediate-risk patients have a 5-year survival rate of about 80% after surgery, and the 5-year survival rate for high-risk and very high-risk patients varies from 10% to 50%. Different adjuvant treatments should be selected for patients with different risk levels. 1) Low-risk patients:There are no recommended adjuvant treatment options, preferring to prevent the emergence of new primary foci and focusing on observation. 2) Patients at intermediate to high risk:High-dose adjuvant interferon therapy may prolong relapse-free survival, but the impact on overall survival needs to be continued to be explored. Clinical decisions must be made in the context of the individual patient’s situation and willingness to treat. 3) Very high-risk patients:There is no standard treatment protocol, but high-dose interferon alpha-2b therapy remains the mainstay, as in the treatment of medium- and high-risk patients. For mucosal melanoma, adjuvant chemotherapy is recommended, please refer to the article “Mucosal melanoma”. 3.Adjuvant radiotherapy It is generally believed that melanoma is not sensitive to radiotherapy, but in some special cases radiotherapy is still an important treatment. Adjuvant radiotherapy for melanoma is mainly used for lymph node dissection and postoperative supplementary treatment of certain head and neck melanomas (especially nasal), which can further improve the local control rate. 4. Systemic therapy for stage III or metastatic melanoma that cannot be surgically removed Stage III or metastatic melanoma that cannot be surgically removed is generally recommended for systemic therapy based on internal medicine or recommended for clinical trials. Patients initially diagnosed are first recommended to undergo genetic testing, and treatment options are selected based on the results of the genetic mutation and the speed of disease progression, including PD-1 monoclonal antibody, CTLA-4 monoclonal antibody, BRAFV600 inhibitor, CKIT inhibitor, MEK inhibitor, high-dose IL-2 and chemotherapy. Specific treatment options need to be chosen by clinicians based on the patient’s condition.