Approximately 40,300 patients are diagnosed with cutaneous melanoma annually in the United States with a disease-related mortality rate of approximately 7,300 per year. Although treatment strategies have been defined for cutaneous melanoma, therapeutic approaches for this hormonally sensitive tumor are difficult in the gravid patient. Epidemiologic studies suggest that there continues to be an increasing incidence of melanoma with an associated decrease in age at presentation for patients in the United States. These trends suggest that approximately 35% of women will be diagnosed with melanoma during their childbearing years. Hence, the perplexing challenge of melanoma management during pregnancy will perhaps increase over the next decade. This case report documents the occurrence of cutaneous melanoma in women during pregnancy and highlights key issues in the natural history of this disease. Detailed review of the current literature related to melanoma during pregnancy will provide insight into optimal therapeutic approaches.