A review was conducted of 264 consecutive patients who underwent surgical treatment for nodal metastases of the groin area from a primary melanoma of the lower extremity. We found no significant difference in survival or regional control created by the extent of node dissection performed, whether or not surgical treatment was a superficial femoral (n = 133) or an iliac and femoral node dissection (n = 131). We also determined that the age and sex of the patient, the location of the primary melanoma and the time that elapsed before the development of nodal metastases were not significant factors. However, the extent of tumor burden (the number of positive nodes and presence of extranodal disease) was useful in predicting patient survival and subsequent nodal basin relapse. Future improvement in survival rates will require effective systemic regimens rather than radical surgical treatment alone.