In melanoma patients, the prognostic value of tumor depth, Clark's level, the presence of ulceration, and regional involvement have not been clearly documented in the pediatric population. This report correlates these factors in a population-based study of patients under the age of 20 years. Of the initial 35 melanoma patients registered in southern Alberta with the Alberta Cancer Board, 14 were found on review to have a diagnosis other than melanoma. In the remaining 21 cases the diagnosis of melanoma was confirmed. There was a suggestion that patients with deeper lesions had a worse prognosis, but this was statistically confirmed only using Clark's levels. The children were then compared with all melanoma patients diagnosed in southern Alberta over the same time period. There was no difference in tumor depth, Clark's level, ulceration, regional involvement, or survival between these two groups. The natural history in children appears to be similar to that of the adult population, contrary to previous reports suggesting a markedly worse prognosis.