Abstract Background Our aim was to investigate the role of melanoma subtype on survival and focus on the effects stratified by Breslow thickness and ulceration status. Methods Patients with cutaneous melanoma stage I/II/III, diagnosed between 2000 and 2014 were derived from the Dutch Nationwide Pathology Registry and overall survival data from the Netherlands Cancer Registry. Patients were followed until 2018. Using multivariable Cox proportional hazards models, hazard ratios (HRs) were calculated for each melanoma subtype, per Breslow thickness category and ulceration status, and adjusted for age, gender, stage and localization. Results 48,361 patients were included, 79.3% had superficial spreading melanoma (SSM), 14.6% nodular melanoma (NM), 5.2% lentigo maligna melanoma (LMM) and 0.9% acral lentiginous melanoma (ALM). In the total patient group, using SSM as the reference category, adjusted hazard ratios were 1.06 (95% CI = 1.01-1.12) for NM, 1.02 (95% CI = 0.93-1.13) for LMM and 1.26 (95% = CI 1.06-1.50) for ALM. Among patients with ≤1.0mm Breslow thickness and no ulceration, NM showed a two-fold increased risk (HR 1.96, 95% CI = 1.58-2.45) compared to SSM. Compared to ≤ 1.0mm SSM without ulceration, the HR for ≤1.0mm SSM with ulceration was 1.94 (95% CI = 1.55-2.44), and that for ≤1.0mm NM with ulceration 3.46 (95% CI = 2.17-5.50). Among patients with >1.0mm tumours NM did not show worse survival than SSM. Conclusion In this large nationwide study ALM patients showed worse survival than SSM patients. NM subtype also showed worse survival than SSM; this was especially clear among patients with melanomas that were thin (≤1.0mm).