OBJECTIVES: The aim of this study is to document treatment patterns of care and associated costs of metastatic melanoma in Brazil from the Public Health System (SUS) Perspective. METHODS: A review of a government administrative claims database (Outpatient Information System - SIA/DATASUS) was conducted from Jan 2008 to June 2010. Patients receiving radiotherapy and/or systemic therapy for diagnosed melanoma (International Code of Disease (ICD-10) C43) stage IV were included in the analysis. Information on type of treatment (chemotherapy, radiotherapy), chemotherapy scheme, length of treatment and associated costs (in 2010 USD) were collected. RESULTS: 2,488 patients met the inclusion criteria, 54.3% male with an average age (SD) of 56.3 (15.0) years. 42.2% lived in the Southeast region and 38.5% in the South. Less than 40% of the cases had the primary cancer site reported. Dacarbazine was the most widely used agent (administered to 1,700 patients), followed by interferon (1,059 patients) and cisplatin (435 patients). Dacarbazine monotherapy was the most commonly administered chemotherapy regimen (37.9% of the patients; average length of treatment of 3.1 months), followed by interferon monotherapy (30.1% of the patients; average length of treatment of 4.6 months) and paclitaxel monotherapy (3.5% of the patients; average length of treatment of 2.8 months).  Overall cost of care expenses were USD16,238,160, 99% of the cost was attributable to chemotherapy (USD16,024,555). Total expenses in 2009 (USD6,667,687) increased 12% compared to 2008; interferon monotherapy accounted for 38.5% (USD6,245,742) of expenses, and dacarbazine monotherapy accounted for 32.2% (USD5,230,315). CONCLUSIONS: Patients with advanced melanoma, in the Brazilian Public Healthcare System (SUS), nearly all receive systemic therapy. Dacarbazine as single agent is the most common regimen, followed by interferon with a significant financial impact to the Public Healthcare System, totalizing USD16,238,160 in the last two and a half years.