Abstract Introduction Mucosal melanoma (MM) is a rare disease, accounting for approximately 1.4% of all melanomas and only 0.03% of all new cancer diagnoses [1]. Traditionally, it is associated with a poor prognosis with an overall 5-year survival rate of less than 25%[1]. Progress in treatment has been hindered by rarity and lack of evidence. Studies however of treatment of subcutaneous melanoma with immunotherapy have demonstrated a significant improvement in survival rates and have become a core part of oncological strategy. This paper will discuss revision of the evidence for the use of immunotherapy in the Head and Neck. Design A systematic review was conducted on 19/01/2019. Medline and Embase databases were searched. 509 articles were collated, of which 52 met the inclusion criteria. Results Results were shown as a comparison of yearly survival rates following different treatment modalities (immunotherapy vs non-immunotherapy) at 2 years, 3 years, and 5 years respectively. Conclusions Immunotherapy outcomes in small studies have shown good data for increasing survival rates at all yearly intervals in MM of the head and neck. Larger clinical trials should be done to accurately distinguish efficacy and survival outcomes of immunotherapy when compared to treatment modalities excluding immunotherapy. The ability to perform larger trials are, however, limited by the rarity of MM of the head and neck.