OBJECTIVES: Australia has the highest incidence of melanoma in the world, however little published information exists regarding treatment patterns. A study was undertaken to define current treatment options offered to Australian patients. METHODS:  A survey was developed from interviews with 7 scientific experts treating melanoma in Australia.  Algorithms outlining referral and treatment patterns across all stages of melanoma were derived and validated by dermatologists and general surgeons for early stage and medical oncologists for later stage disease. RESULTS: A total of 115 oncologists were identified as treating melanoma in Australia and 26% of those responded. In addition, a sample of 40 dermatologists and surgeons were contacted and 43% of those participated.  Results demonstrated that nearly all patients with local or locoregional melanomas undergo radical excision of their primary lesion; whereas 73.1% of patients with metastatic melanoma have their primary lesion excised. For metastatic disease, the majority of oncologists reported that current 1st line chemotherapy is dacarbazine (DTIC) (85%) or fotemustine (77%), although a large percentage also reported enrolling patients in clinical trials (73%). Nine oncologists (36%) surveyed indicated that they expect overall survival (OS) of 7-9 months after initiation of 1st line chemotherapy.  Oncologists also reported that 48% of patients who relapse after 1st line therapy receive 2nd line therapy, of which enrollment into a clinical trial (69%) or treatment with fotemustine (62%) are the most common treatment options. Approximately half (48%) of oncologists surveyed expect OS in 2nd line to be 3-6 months. The most common sites for development of metastases were reported to be lung (48.0%), liver (47.6%) and brain (38.0%).   CONCLUSIONS:  To our knowledge, this is the first survey conducted to understand melanoma treatment patterns in Australia. This study provides information for evidence-based decision makers to understand how health resources are utilised in the treatment of melanoma in Australia.