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Possession of a higher than average number of nevi has long been substantiated as one of several factors that predispose patients to malignant melanoma. Despite the relative certainty of this relationship, little is known about the relationship between the number of nevi a person possesses and risk of death from melanoma. A cohort of melanoma patients was followed prospectively to determine if a significant relationship exists between number of nevi and increased mortality from melanoma. Age at diagnosis, melanoma of the head and neck, increasing Breslow thickness and presence of mitoses all were associated with poorer survival in our multivariate analysis. Existence of a dermal nevus at the site of melanoma was also associated with poorer survival, while solar elastosis and skin awareness were associated with improved survival. Our study also suggests that having a large number of nevi increases the risk of death from melanoma more than two-fold. Further research elucidating the prognostic indications of a high number of nevi possessed by melanoma patients could potentially lead to considerable advances in the classification, diagnosis, and therapy for cutaneous melanoma.