OBJECTIVES: To assess health care resource utilization and costs among patients with metastatic melanoma in real world practice setting.  METHODS: Using a large US medical claims database, patients were identified between 2005 and 2010 using ≥2melanoma diagnoses (ICD-9-CM: 172.xx, V10.82) and ≥2 diagnoses for metastasis (ICD-9-CM: 197.xx, 198.xx). The index date was the first date of metastasis diagnosis. Patients who had other primary malignant tumors prior to the melanoma diagnosis, were younger than 18 years old at the index, or had a pre-index period of less than 6 months, were excluded from the analysis. Patients were followed from the index date to death, disenrollment, or end of the study period (June 30, 2010), whichever occurred first. Health care utilization and health care costs (adjusted to 2010 dollars) were examined per patient-year for office visits, outpatient visits, emergency room (ER) visits and inpatient hospitalization. RESULTS: A total of 2,546 patients with metastatic melanoma were identified. Mean (± standard deviation) age at the index was 60.6 (± 14.0) years and 36.5% were female. Overall, 87.3% of the patients had at least one physician office visit with a mean of 24.0 visits per person-year, 64.7% had an ER visit with a mean of 12.9 visits per person-year, 90.6% had an outpatient visit with a mean of 8.3 visits per person-year, and 82.2% had been hospitalized with a mean of 12.4 hospitalizations per person-year. The mean total costs per patient-year were $117,610, which was driven mainly by inpatient costs ($60,355/patient-year) and outpatient costs ($34,540/patient-year). CONCLUSIONS: Inpatient and outpatient care are key cost drivers in the medical management of patients with advanced melanoma.