Immune checkpoint inhibitors (ICI) and targeted therapies have profoundly altered the management of several cancers over the past decade. Metastatic melanoma has been at the forefront of these changes. We provide here a nationwide overview and an assessment of changes in survival in France. We included 10,936 patients receiving a systemic treatment for metastatic cutaneous melanoma between 2010 and 2017 using the French national health insurance database (SNDS, ex-SNIIRAM). Over the study period, there was a doubling of the number of new patients receiving a systemic treatment. Cytotoxic chemotherapy was progressively replaced by targeted therapy and ICI. Patients having initiated a first-line treatment since June 2015 gained 46% OS compared to those initiating treatment before 2012. 24-month OS rose from 21% to 44%. We provide real-world evidence for the improvement of OS in the past decade among patients with metastatic melanoma. Although the characteristics of the patients treated can vary across periods, this type of exhaustive real-world data provides evidence from broader populations than those included in clinical trials.Copyright © 2020 The Authors. Published by Elsevier Inc. All rights reserved.