Background Adolescent and young adult melanomas show different histopathological characteristics and clinical behaviors from adult melanomas. Objective To describe the histopathological and clinical features pertinent to vicenarian skin melanomas and compare them with adult melanomas using a large cohort from a single institution. Methods A total of 146 melanomas in their twenties and 1139 older melanoma patients were analyzed retrospectively. Results The median age of vicenarian patients was 27 years (ranging from 20 to 29, inclusive). The females predominated over the males (55.5%) and slightly more than half of the tumors were thick (>= 2 mm) (58.6%) and ulcerated (51.6%). Majority of the lesions were associated with favorable prognostic indicators such as non-nodular histotype (68%), lower mitotic rate (<= 3 per mm(2)) (58.1%), low lymphovascular invasion (87.5%), node negativity (70.1%), and nonmetastatic disease (91.8%). Compared to adult melanomas, vicenarians were mostly females (P = .009), and their lesions were significantly BRAF-mutant (P = .04). Nevertheless, vicenarian melanomas were not associated with other major prognostic parameters, such as thickness, ulceration, mitotic rate, nodal involvement, or metastasis. The recurrence and death rates between age groups were found similar (P = .5 and P = .1, respectively). The 5-year disease-free survival rates for vicenarians v adult melanomas were 62.6% and 57.4%, respectively (P = .4). Likewise, 5-year overall survival rates in vicenarians and older group were 68.1% v 60%, respectively, (P = .1). Conclusion Since both the vicenarian and adult melanomas are associated with same clinicopathological indicators they share similar survival rates.