As systemic therapies for melanoma have improved, the number of patients living with metastatic disease has similarly increased. Hence, surgeons are increasingly being asked to evaluate patients for resection of metastatic disease. Number and location of metastases, response to previous treatments, mutational status, and disease- free interval are important points of con­sideration. Such decisions are best made in the context of a multidisciplinary tumor board dis­cussion, in which representatives from medical oncology, surgical oncology, pathology, radiol­ogy, and radiation oncology are present to render their opinions. Prior to surgical resection, consid­eration should be given to the use of neoadjuvant immunotherapy, whether alone or in combina­tion, or BRAF/MEK-targeted therapies for patients with actionable melanoma mutations [32]. Such therapies have been shown to be asso­ciated with associated with improved event-free survival when followed by adjuvant therapy [33]. The surgeon considering metastasectomy must carefully select patients offered surgery. In the era of modern systemic treatment, resection of metastatic disease is associated with improved overall survival, particularly for patients with metastatic disease to the gastrointestinal tract who undergo curative surgical resection [34]. Surgical resection thereby remains an important component of multidisciplinary melanoma care in the era of effective immunotherapy and tar­geted systemic therapies.