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Po-Yu Chu,1 Kuan-Po Lien,2,3 Kuan-Cheng Chen,1 Cheng-Yuan Li,4,5 Jai-Sing Yang,6 Tien-Hsiang Wang,1,7 Yu-Jen Chiu1,7,8 1Division of Plastic and Reconstructive Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, 112201, Taiwan; 2Department of Medicine, Mackay Medical College, New Taipei City, 252005, Taiwan; 3Department of Surgery, Cathay General Hospital, Taipei, 106438, Taiwan; 4Department of Dermatology, Taipei Veterans General Hospital, Taipei, 112201, Taiwan; 5Department of Dermatology, School of Medicine, National Yang Ming Chiao Tung University, Taipei, 112304, Taiwan; 6Department of Medical Research, China Medical University Hospital, China Medical University, Taichung City, 404327, Taiwan; 7Department of Surgery, School of Medicine, National Yang Ming Chiao Tung University, Taipei, 112304, Taiwan; 8Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, 112304, TaiwanCorrespondence: Yu-Jen Chiu, Division of Plastic and Reconstructive Surgery, Department of Surgery, Taipei Veterans General Hospital, 19/F, No. 201, Sec. 2, Shipai Road, Beitou District, Taipei, 112201, Taiwan, Email chiou70202@gmail.comBackground: Obesity has been identified as a significant risk factor for various diseases, including certain cancers; however, its association with melanoma remains a subject of debate. Despite the increasing incidence of cutaneous melanoma in Taiwan, there has been limited research on its correlation with obesity. This study aims to investigate the relationship between obesity and the prognosis of cutaneous melanoma in Taiwan.Methods: Between January 1, 2000, and December 31, 2022, 201 patients were diagnosed with cutaneous melanoma at our hospital, with 61.69% of them diagnosed with acral melanoma. Data on body weight, height, tumor stages and prognosis were collected and analyzed.Results: The result revealed that older age (≥ 65 years old), male, advanced Breslow thickness stage (T3 and T4) and tumor ulceration were identified as risk factors for worse overall survival in both cutaneous melanoma and acral melanoma. In the adjusted multivariable analysis, being overweight was considered a protective factor in both cutaneous and acral melanoma.Conclusion: Contrary to expectations, it was observed that melanoma patients with obesity exhibited better survival rates compared to those with normal or underweight status. Additionally, no significant differences were found between acral melanoma and non-acral melanoma subtypes regarding the impact of body weight on overall survival.Keywords: melanoma, neoplasms, obesity, obesity paradox, survival analysis