OBJECTIVES:  To assess melanoma specific health-related quality of life (HRQoL) and health states in patients with earlier stage metastatic (IIIb/c-IVM1a) and late stage metastatic (IVM1b/c) melanoma METHODS:  Data were collected from the Adelphi Real World Advanced Melanoma Disease-Specific Programme^©, a cross-sectional survey of 243 physicians and their patients (n=1881). Data were collected between March and July 2016 in 5 major European countries (FR, GE, SP, IT & UK). A subset of 660 patients completed the Functional Assessment of Cancer Therapy Melanoma (FACT-M) and EuroQol-5D (EQ-5D) one time. Patients were classified by stage of melanoma at time of consultation. Descriptive analyses of HRQoL scores between groups were assessed using Mann-Whitney U tests RESULTS:  The mean age of the earlier and late stage metastatic patients sampled was 57 and 59 respectively. More earlier stage metastatic patients had an ECOG status of 0 or 1 versus late stage metastatic patients (80%, 75% respectively). A greater proportion of late stage metastatic patients required caregiver support (42%) and had a longer median time since primary diagnosis (6 months) versus earlier stage patients (30% and 5 months). Patients with earlier stage metastatic melanoma had better mean EQ-5D index scores versus late stage (0.75 (n=325), 0.67 (n=324); p=0.0120). Higher scores indicating better HRQoL were observed between the earlier and late stage metastatic melanoma patients for the FACT-M (116.4 (n=315), 108.8 (n=307); p=0.0014) and subscales (except Emotional Well Being). Clinically meaningful differences between groups using published minimal important differences (MIDs) were observed for 3/7 FACT-M subscales and the EQ-5D index score. CONCLUSIONS:  Differences in HRQoL and health states were observed between earlier stage and late stage metastatic melanoma populations, highlighting the detrimental effect of developing late stage metastatic disease. These results suggest that treatments that delay progression of the disease are important to conserve patients HRQoL.