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Giant congenital melanocytic nevi (GCMN) are rare lesions that are present in 1 in every 20,000 new births. A 10-year review of all patients treated at a pediatric burn center was performed with the goal of identifying the characteristics of patients with GCMN and the outcomes of the treatment provided in a burn center. Thirty-six patients met the definition of GCMN; 64% were female and 36% were male. The most common ethnicity was white (47%), followed by Latino (19%). Most patients were between the ages of 1 and 10 years at the time of their first procedure (64%), and the mean age of patients at the time of their first procedure was 7 years. Eighty-nine percent had only one lesion. The most common location of lesions was the face (64%), followed by the scalp (17%) and back (17%). Seventy-four percent of the samples sent to pathology were congenital compound melanocytic nevi, and 20% were congenital intradermal melanocytic nevi. None of the lesions contained malignant changes at the time of the pathological examination. The various treatment modalities provided in the burn unit are reviewed. The authors conclude that the burn unit is an ideal setting for the treatment of GCMN.