A large number of clinical studies are being conducted to assess the effects of angiogenesis inhibitors in the treatment of patients who have metastatic melanoma. It has become increasingly clear that a therapeutic approach that combines angiogenesis inhibitors with cytotoxic agents or other treatment modalities is more likely to result in a clinical benefit for patients rather than antiangiogenesis treatments alone. However, a targeted treatment approach with antiangiogenic agents needs to be based on an in-depth understanding of the complex mechanisms involved in melanoma tumor angiogenesis.