The incidence of malignant cutaneous melanoma is rising. Imaging studies represent a major component of the staging work-up and follow-up of melanoma patients and are used to facilitate preoperative planning and intraoperative management. Study benefits are not clear, and evidence does not support any particular protocol for their use. The National Comprehensive Cancer Network’s updated guidelines for use of imaging studies in melanoma patients represent a consensus based on lower level evidence, including clinical experience. The utility of individual imaging studies in melanoma patients depends on disease stage. Chest radiography, CT, MRI, lymphoscintigraphy, ultrasonography, PET, and PET/CT have specific roles in patient evaluation. Clinicians must use available evidence to guide decisions regarding which imaging modalities are appropriate for a given indication.