Anorectal melanoma represents approximately 0.2-1% of all malignant melanomas and has a poor prognosis, with a median survival of 8 to 23 months after the time of diagnosis. The typical treatment modalities include surgery, radiotherapy and chemotherapy. The particular approach taken depends on the patient's status and disease stage. Although there are different treatment options for this rare condition, there are not enough studies on multimodality treatment. Here, we present the case of a 54-year-old female with anorectal melanoma that had metastasized to an inguinal lymph node. She underwent local excision of the rectal mass and inguinal lymph-node dissection. Temozolomide treatment was started after radiotherapy and was given for 24 months. Follow-up revealed that the patient has been doing well with no signs of recurrence three years after the completion of treatment. We aim to discuss combined treatment modalities for ARM in light of the pertinent literature.