Abstract: Objective To study the postoperative mental state, living quality in patients with primary malignant melanoma (MM), to analyze the correlation between postoperative mental state and living quality, to find the risk factors of influencing postoperative living quality, and to provide reference for formulating postoperative nursing plan of primary MM patients. Methods The clinical data of 60 primary MM patients with surgical treatment from February 2016 to March 2017 were retrospectively analyzed. The general data of patients were investigated. The postoperative 4w, 12w, 24w mental state of patients were evaluated by Hamilton anxiety scale (HAMA), Hamilton depression scale (HAMD), general self-efficacy scale (GSES). The postoperative 4w, 12w, 24w living quality of patients were evaluated by European Organization for Research and Treatment of Cancer Quality of Life Core Questionnaire C30 (EORTC QLQ-C30). The correlation between postoperative mental state and living quality was investigated. The risk factors of influencing postoperative living quality were analyzed by single-factor and multiple-factor analysis. Results After surgery, the HAMA scores of patients had no significant changes, and there was no statistical difference in the HAMA scores at each time (F=0.437,P>0.05); The HAMD scores decreased and GSES scores increased as the time extended, and there was statistical difference in the HAMD and GSES scores at each time (F=10.476、12.840，P<0.05); The postoperative 4w living quality score was the lowest, the scores of postoperative 12w and 24w living quality scores increased compared with postoperative 4w scores; The postoperative 4w total scores of living quality was the highest, but it showed decreased trend as time extended, and there was statistical difference in the living quality scores and total scores at different time (F=19.567, 20.710, 10.152, 8.717、6.421, 8.357, 43.015, P<0.05); The living quality of primary MM patients had negative correlation with anxiety and depression (r=-0.572, -0.323, P<0.05), but had positive correlation with general efficacy (r=0.356, P=0.000); According to single-factor analysis, the low education level, advanced age, high medical cost, surgical procedure with extended resection, postoperative chemoradiotherapy, postoperative flap sensory disorder, obvious postoperative pain, severe postoperative depression, severe postoperative anxiety were main factors of causing poor living quality ( χ2=6.782, 4.348, 4.290, 11.650, 3.956, 4.319, 4.538, 10.576, 12.918, P<0.05); According to multiple-factor analysis, the advanced age, low educational level, high medical cost, extended resection, flap sensory disorder, severe postoperative pain, moderate-severe postoperative depression and anxiety were independent risk factors of influencing living quality in primary MM patients (OR=4.600, 3.200, 3.190, 3.250, 3.000, 3.643, 3.250, 10.909, 9.625, P<0.05). Conclusion The negative mental state of primary MM patients after surgery within half a year is the key factors of decreasing living quality. The advanced age, high medical cost, postoperative flap sensory disorder, extended resection are main factors of influencing living quality. Therefore, as for the patients with symptoms above, it is necessary to provide scientific nursing intervention, so as to improve their living quality.