Forty patients with vulvar melanoma were registered at the MD Anderson Hospital and Tumor Institute from March 1944 to April 1970. The 30 previously untreated patients were retrospectively staged and the results of treatment evaluated. The gross 5-year survival rate among 14 eligible patients was 50%. Prognosis is related to stage. Clinically positive regional nodes is an ominous finding. Radical vulvectomy and bilateral groin node dissection constitute the minimum treatment. In most cases bilateral pelvic lymphadenectomy should be included. The vaginal-urethral margin of resection is the most frequent point of failure with this management.