Objective: To determine the changing incidence of and mortality from cutaneous malignant melanoma in Scotland from 1979 to 1994. Design: Detailed registration of clinical and pathological features, surgical and other treatment, and follow up of all cases of cutaneous malignant melanoma diagnosed from 1979 to 1994 and registered with specialist database for Scotland. Setting: Scotland. Subjects: 6288 patients with invasive primary cutaneous malignant melanoma diagnosed between 1 January 1979 and 31 December 1994. Results: The annual age standardised incidence of cutaneous malignant melanoma rose significantly from 3.5 to 7.8 per 100 000 per year in men and from 6.8 to 12.3 per 100 000 per year in women (PConclusions: In Scotland the incidence of melanoma in women has stabilised, while mortality associated with melanoma in women shows a downward trend. Data from Scotland based on 6288 patients with primary invasive cutaneous malignant melanoma show a rise overall in the incidence of melanoma over 15 years but a stabilisation in the incidence of melanoma in women under 65 since 1986 Mortality associated with melanoma is now falling in women of all ages, especially in women under 65 Survival prospects remain strongly related to tumour thickness at the time of diagnosis: disease free survival at 5 years for patients with melanoma thinner than 1.5 mm was 96% in women and 91% in men, while for those with tumours thicker than 3.5 mm survival was 54% and 42% respectively