This review focuses on the surgical treatment of primary cutaneous melanoma. Interpretation of biopsy results and a rational approach to preoperative screening methods for metastases are examined. The marked changes in operative approach to melanoma over the past century are reviewed, with emphasis on the impact of prospective, randomized trials upon the width of surgical margins for melanoma, General principles of current surgical technique are discussed, with attention given to modifications of technique dictated by unique anatomic tumor sites. (C) 1996 Wiley-Liss, Inc.