The last decades were characterized by a worldwide increasing incidence in melanoma. Almost 35% of diagnosed with melanoma women are in childbearing age. Malignant melanoma is the most common malignancy during pregnancy. Considering this background it is clear how melanoma and pregnancy has becoming one of the main topic of discussion. Current knowledge about pregnancy and melanoma is characterized by many controversies and divergences. The real incidence of melanoma in childbearing and the impact of pregnancy on the prognosis of melanoma is still unclear. There are many uncertainties regarding other aspects of women with melanoma during childbearing, such as the changing in moles, the prognosis and the management. Every changing nevus that would raise concern for malignancy in a pregnant patient should be investigated and surgery should be performed safely using local anesthetic. Pregnancy can affect the staging and treatment of melanoma especially in advanced stage, the decision about introduction or continuation of treatment in the event of pregnancy should be preceded by an analysis of the potential benefits and risks. The role of hormonal changes during pregnancy on melanoma is continually debated. At present, there is a lack of a European guideline on this topic and this review aims to address the most controversial issues such as the roles of hormones, staging and therapeutic difficulties of melanoma during pregnancy. The authors' aim is to help the clinician in the difficult decision-making process concerning the woman suffering from melanoma and her child.