Objective To explore the effect of toripalimab combined with conventional chemotherapy on immune function and skin condition satisfaction in patients with melanoma. Methods A total of 96 patients with melanoma admitted to Shishou People's Hospital from January 2023 to December 2024 were selected as the research subjects, and they were divided into the control group and the observation group by the random number table method, with 48 patients in each group. The control group was treated with conventional chemotherapy, and the observation group was treated with toripalimab combined with conventional chemotherapy. The immune function, skin condition satisfaction, clinical efficacy and tumor marker levels were compared between the two groups. Results After treatment, the levels of CD3+, CD4+ and CD4+/CD8+ in the observation group were higher than those in the control group, and the level of CD8+ was lower than that in the control group (P <0.05). The skin condition satisfaction of the observation group (93.75%) was higher than that of the control group (77.08%) (P <0.05). The ORR and DCR of the observation group were 62.50% and 77.08%, respectively, which were higher than 41.67% and 56.25% of the control group (P <0.05). The levels of S100 protein, LDH and MIA in the observation group after treatment were lower than those in the control group (P <0.05). Conclusion Toripalimab combined with conventional chemotherapy has a good clinical effect in the treatment of melanoma, which can effectively inhibit the expression of tumor markers, enhance immune function, and improve patients' satisfaction with skin condition.