Melanoma rates in the United States have been rapidly rising over the past 30 years, with estimates of a lifetime risk of 1 in 40 for women and 1 in 27 for men, based on 2022 data from the American Cancer Society. Risk factors for the development of melanoma include fair skin, smoking, sun exposure, multiple moles or nevi, a personal or family history of melanoma, and certain genetic mutations. While most melanomas are cutaneous, they can involve any mucosal surface where melanocytes are found, including the gastrointestinal tract, oropharynx, or retinas. Mucosal and uveal melanomas have an overall different presentation, genetic profile, and cancer management algorithm that extends beyond that required for the general surgical oral boards. The thickness of the melanomas is crucial to determining prognosis and management. Other factors that determine regional disease include ulceration and a high mitotic rate. This chapter will discuss thin cutaneous melanomas—those <1.0 mm in thickness.