Pediatric melanoma is a rare but clinically significant public health concern, as it accounts for 7% of all malignancies in adolescents aged 15 to 19. Given the overall rarity of pediatric melanoma, especially in preadolescents, patients can go undetected, leading to a delay in treatment. We divide pediatric melanoma subtypes into three distinct age ranges-infantile, preadolescent, and adolescent-and distinguish the clinical features, prognosis, and associated risk factors of each age range. We next summarize the three predominant melanoma subtypes-Spitzoid melanoma, congenital melanocytic nevus-associated melanoma, and conventional (adult-type) melanoma-and provide distinguishing clinical, histologic, and genetic features from their difficult-to-differentiate benign counterparts. We conclude by reviewing consensus guidelines for pediatric melanoma staging and treatment, with a special emphasis on outlining barriers to adapting the advancements in targeted therapeutics into the standard care of pediatric melanoma.