Merkel cell carcinoma (MCC) is an aggressive skin cancer that recurs in more than one-third of cases, with reported mortality rates of 33% to 46%. Given this high-risk situation, MCC is often managed with therapies that are aggressive and potentially toxic: extensive surgery, radiation therapy (RT), and systemic therapy. Fortunately, recent advances in multiple realms now allow MCC management to be more effective and less toxic. In this Viewpoint, we highlight 3 recent developments relating to progress in local management, early detection of recurrent disease, and systemic therapy. Although it is not practical for physicians who rarely see patients with MCC to remain up-to-date on the details of management, herein we provide resources and guidelines to help physicians ensure optimal initial care and participate in longitudinal treatment of patients with MCC.