Lentigo maligna (LM) accounts for approximately 5–15% of all melanoma cases and is strongly associated with chronic sun exposure and high cumulative sun damage (CSD). The term lentigo maligna is currently used to describe both in situ and invasive melanomas of this morphologic subtype, whereas historically, it referred exclusively to melanoma in situ. Histopathologically, LM initially demonstrates an intraepidermal proliferation of atypical melanocytes with confluent growth pattern and may subsequently invade the dermis. In diagnostically challenging cases, immunohistochemical evaluation with pan-melanoma antibody cocktail, SOX10, and PRAME can aid in distinguishing LM from pigmented actinic keratosis or melanocytic hyperplasia. Given that lentigo maligna melanoma (LMM) represents a high-CSD subtype, it displays a distinct molecular profile, characterized by KIT aberrations in approximately 28% of cases and a relatively low frequency of BRAF V600E mutations compared with other melanoma variants.