The incidence of multiple primary melanoma is reported as 1–6% of patients with cutaneous melanoma. The patient who already has one melanoma has a greater risk of developing a second primary melanoma than a person who does not have a melanoma. Hence patients with one melanoma require complete skin examinations at regular follow up visits to detect metachronous disease. Dysplastic nevi should also be sought and a family history of melanoma or dysplastic nevi investigated. This report describes a patient who developed four metachronous primary melanomas. Diagnosis, risk factors and management is discussed.