Malignant melanoma is a malignant, neoplastic proliferation of melanocytes that reside within the stratum basale and function to produce melanin, the pigment that gives the skin its color. Melanin’s role is multifaceted, including absorption of ultraviolet (UV) rays and intrinsic antioxidant activity to protect DNA against free radical damage. UV exposure is largely responsible for the tumorigenesis of melanoma, as noted in those who frequently sunbathe or use tanning beds. Although the incidence of melanoma has a strong association with UV exposure, melanoma can arise anywhere melanocytes are present, as seen in cases involving the genitourinary and uveal tracts. Melanoma is the most aggressive form of skin cancer, with the incidence increasing faster than any other malignancy. It is the sixth most common malignancy in the United States. Age is a poor prognostic factor for mortality worldwide. This chapter discusses the risk factors, pathogenesis, diagnosis, and management of melanoma in the geriatric population.