Malignant melanoma is a rare disease in Taiwan with an incidence rate of 0.65/100,000. Excessive exposure to ultraviolet radiation is not associated with most Taiwanese melanoma cases. Acral lentiginous melanoma comprises 58% of cutaneous melanoma. Advanced disease is seen in 50% of cases. Surgery, including resection of the primary melanoma, sentinel lymph nodes that may harbor microscopic metastasis, clinically abnormal lymph nodes, and selected distant metastases, is the most important treatment. Lymphatic mapping and sentinel lymph node biopsy has changed the clinical stage in 22.2% of our patients. Adjuvant high-dose interferon significantly prolongs progression-free survival. However, its use in Taiwan is limited by its substantial toxicity. The prognosis of metastatic disease remains poor with a median survival of 12 months. In the past, chemotherapy alone was the most common treatment modality for metastatic disease. Recently biochemotherapy has been more commonly utilized to treat patients with metastatic melanoma.