The purpose of this paper is to discuss the pros and cons of Mohs micrographic surgery (MMS) for the treatment of lentigo maligna (LM), which is the in situ phase of a subtype of malignant melanoma that typically develops on sun-damaged skin of the head and neck of elderly patients. The use of frozen section processing in MMS for the treatment of LM has been questioned by many pathologists and dermatologists, and remains controversial. We review the MMS technique, and discuss the advantages and disadvantages of treating malignant melanoma with MMS, specifically LM of the face.