Cutaneous melanoma poses an evolving public-health challenge in China, with an epidemiological profile distinct from that of Western populations. Using data from the Global Burden of Disease Study 2023, we assessed the burden of malignant skin melanoma in China from 1990 to 2023, including prevalence, incidence, mortality, years lived with disability, years of life lost, and disability-adjusted life years (DALYs), and applied joinpoint regression, an intrinsic-estimator age–period–cohort (APC) model, and autoregressive integrated moving average (ARIMA) forecasting to 2033. Age-standardized prevalence rose from 1.39 (95% uncertainty interval [UI]: 0.82, 2.15) to 5.03 (95% UI: 3.17, 8.48) per 100,000; sex-specific prevalence rose approximately 3.38-fold in males and 2.13-fold in females, whereas mortality fell from 0.33 to 0.27 per 100,000 despite rising incidence. Period effects showed the largest variation (1.32 units for males, 0.97 for females), exceeding cohort and age effects and indicating contemporaneous factors as the principal drivers. Joinpoint analysis revealed acceleration after 2013 in males (APC 1.32% → 2.93%) and four phases in females. Sex patterns reversed by 2023, with males showing higher mortality (ratio 1.08) and DALYs (ratio 1.23), while the mortality-to-incidence ratio approximately halved in both sexes. ARIMA projected continued mortality decline (37.0% overall) through 2033, with wide long-term uncertainty. Melanoma burden in China has been transformed—markedly higher prevalence alongside falling mortality—driven predominantly by period rather than demographic effects. Interpreted in light of the acral lentiginous subtype prevalent in Chinese patients, these findings support population-specific prevention and early-detection strategies beyond ultraviolet-based paradigms.