Melanoma (also known as malignant melanoma) is a potentially lethal cancer whose incidence has increased significantly over the last several decades. Although it is ranked as the 17th most common cancer worldwide, melanoma ranks fifth for the most common cancer among both men and women in the United States. It has been strongly linked to intense sun exposure, fair-skinned populations, and several genetic conditions. Abnormal skin lesions identified on exam warrant a total-body skin examination and an excisional biopsy prior to definitive treatment. Wide local excision involves excision of a primary tumor with adequate margins. This method of excision not only ensures appropriate staging but also reduces local recurrence by eliminating actively spreading disease. Even with reduced mortality after advances in treatment, there remains an opportunity to improve outcomes in patients with advanced disease.