Melanoma is a highly aggressive cancer that represents a significant disease burden, making diagnosis and appropriate control of disease vital for improving morbidity and mortality. The most recent guidelines for melanoma treatment advise performing a sentinel lymph node biopsy for intermediate thickness melanomas, with subsequent completion lymph node dissection (CLND) if sentinel nodes are positive. This guideline is controversial due to the limited availability of data on this topic. CLND is an extensive surgery with known risks and complications and a small survival benefit. However, in patients without significant comorbidities and at low risk for surgery, the survival benefit outweighs the procedural risk. This article reviews CLND and the current recommendations.