OBJECTIVES: The worldwide incidence of melanoma is increasing rapidly. Two chemotherapy regimens are used for treatment of Malignant Melanoma: single agent intravenous Dacarbazine (DTIC) and oral Temozolomide (TMZ). TMZ has greater cost in Iran so we aimed to conduct a meta analysis to compare the efficacy of two drugs. METHODS: To compare the efficacy of these two drugs, a systematic review and meta-analysis were conducted and published articles, comparing use of  Dacarbazine and Temozolomide in treatment of Malignant Melanoma were reviewed. For this purpose, Pubmed, Scopous, Web of Science and Cochrane Central Register of Controlled Trials were searched and the search terms were: “Dacarbazine” and “Temozolomide” and “ Malignant Melanoma”. Data were collected from inception to 2012. “Response to treatment” includes:” complete response (CR)”,” partial response (PR)” and “stable disease (SD)” and side effects  were  the key outcomes of interest. RESULTS: The meta-analysis included 3 RCTS and involved 1314 patients with malignant melanoma. Approximately half of them were allocated to the TMZ arm and half to the DTIC arm. Comparison of TMZ with DTIC yielded a nonsignificant  relative risk (RR) of 0.83 (95% confidence interval of 0.26-2.64, P=0.76) for  complete response. A nonsignificant  RR of 1.35 (95% CI of 0.95-1.91, P=0.1) for partial response. A nonsignificant RR of 1.05 (95% CI of 0.85-1.3, P=0.65) for stable disease and a nonsignificant RR of 1.15 (95% CI of 0.74-1.79, P=0.55) for fatigue ( a side effect). CONCLUSIONS: The potential value of oral versus intravenous chemotherapy is obvious but  considering health outcome and not significant difference in efficacy between these two drugs and that TMZ even does not have less side effects and has higher cost of treatment in Iran, we suggest DTIC as a first-choice treatment for Malignant Melanoma.