Melanoma is a potentially aggressive skin cancer with a steadily rising incidence. Most melanomas are diagnosed at an early stage and associated with an excellent prognosis when treated appropriately. Primary treatment for melanoma is surgical. Wider surgical margins and a variety of techniques for comprehensive histologic margin assessment may be considered for lentigo maligna type melanoma on the head and neck, due to characteristic broad subclinical extension. For invasive melanoma, sentinel lymph node biopsy may be indicated for staging, and to guide further management and follow-up. Appropriate treatment guidelines for early-stage melanoma are reviewed and discussed.