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Melanoma is one of the most dangerous tumors due to its high-grade malignancy. Though patients in early stage can be completely cured by surgery, for high-risk cases (stage ⅡB-Ⅳ), adjuvant therapy is of great importance to prolong the survival and improve the prognosis. In recent years, thanks to the booming development of systemic regimen, the perioperative managements for stage Ⅲ cases have been continuously evolving. In the current paper, we focused on the role of lymph node biopsy and surgical resection, postoperative adjuvant therapy options, as well as the cutting-edge neoadjuvant therapy development, aiming to provide new perioperative strategies for stage Ⅲ melanoma patients.