The incident of cutaneous melanoma continues to accelerate throughout the world. There are both an increase in incidents as well as increased mortality throughout both the United States and the remainder of the world. Prevention and early detection are our greatest weapons against this potentially fatal disease. Tumor thickness has long been the established means of stratifying risk for both metastatic disease as well as death. Presentation will focus on surgical management of the disease. Adequate resection at the primary site will be detailed including the challenges facing head and neck surgical oncologists. It is critical to balance the oncologic resection with preserving form and function in the head and neck region. Strategies of assuring margin-negative resection will be detailed. The strategy of employing lymphoscintigraphy with sentinel lymph node biopsy will be detailed in the patients with at-risk primary disease who are clinically N0 on both clinical examination and radiological evaluation. Lymphoscintigraphy can be extremely challenging in the head & neck region, and the presenter will focus on surgical technique and nuances of surgical management. Outcomes for lymphoscintigraphy will be detailed and challenging case presentations will be incorporated. There will also be limited discussion of the use of adjuvant therapy including radiation therapy, chemotherapy, and immunotherapy.