It has been suggested that ultrasound examination of regional lymph nodes provides staging and prognostic information that is as accurate as sentinel node biopsy in patients who present with cutaneous melanoma. However, in most studies the sensitivity of ultrasound in detecting nodal metastasis has been low (23% in a recent large series). For the present, sentinel node biopsy remains the most accurate method of regional node staging in patients with newly diagnosed melanoma. J. Surg. Oncol. 2011; 104:354–360. © 2011 Wiley-Liss, Inc.