High serum concentration of lactate dehydrogenase (LDH) is associated with poor prognosis in patients with metastatic cutaneous melanoma. Herein, we present a case of a 92-year-old patient with metastatic melanoma and negative prognostic factors treated with anti-PD-1 antibody nivolumab. The therapy yielded excellent clinical results: significant regression of metastatic lesions and improvement in the patient’s performance status. The presented case confirms previously reported observations regarding high clinical activity and acceptable safety profile of nivolumab in elderly patients.High serum concentration of lactate dehydrogenase (LDH) is associated with poor prognosis in patients with metastatic cutaneous melanoma. Herein, we present a case of a 92-year-old patient with metastatic melanoma and negative prognostic factors treated with anti-PD-1 antibody nivolumab. The therapy yielded excellent clinical results: significant regression of metastatic lesions and improvement in the patient’s performance status. The presented case confirms previously reported observations regarding high clinical activity and acceptable safety profile of nivolumab in elderly patients