Mast cell tumours are the subject of many research articles and CPD talks. That is partly because they are common, but also because they do not have a set of clear diagnostic and treatment paths like other tumours do. They present in so many different ways and there are an overwhelming number of treatment and diagnostic options which can also be used in any number of combinations. Whilst making a treatment algorithm which applies to every mast cell tumour is impossible (after many failed attempts!), this lecture presents clear information on what the options are and when to use them. It covers: do I need to stage?; do I need to follow my surgery with chemotherapy or tyrosine kinase inhibitors?; multiple mast cell tumours; a focus on new and less common therapies – radiotherapy, Stelfonta®, electrochemotherapy and more.