This chapter describes the diagnosis, treatment, and prognosis for malignant melanoma during pregnancy. Clinical staging traditionally included assessment of the local tumor site and adjacent skin, regional lymph node areas, and distant organs that are frequently the site of metastatic disease. Surgical removal of the melanoma with adequate margins remains the standard primary therapy for early melanoma. Interim Multicenter Selective Lymphadenectomy Trial (MSLT-1) results revealed similar overall 5-year survival benefit between patients who had undergone wide excision and sentinel lymph node biopsy (SLNB) with immediate lymphadenectomy and those who had wide excision and postoperative observation of regional lymph node with lymphadenectomy if nodal relapse occurred. The risk of malformations when chemotherapy is administered in the first trimester is estimated to be around 7.5%-17% for single-agent chemotherapy and 25% for combination chemotherapy. The effect of pregnancy on prognosis of melanoma is a focus of interest in the medical literature for years.