Perineural spread of malignant melanoma is rare but increasingly recognized as a potential mechanism of metastasis particularly in desmoplastic melanoma, which has neurotropic characteristics. In the head and neck, this form of melanoma spread affecting cranial nerves has been described; however, to date, only one case of melanoma spreading to the brachial plexus has ever been reported. We present a case of cutaneous melanoma recurrence below the right jaw with perineural spread along the C3 and C4 nerves into the spinal cord, something which has not been documented previously in the literature.