Incidence of melanoma, an invasive form of skin cancer, is on the rise in Canada. This study examines the association between tanning equipment (TE) use and risk of a second or higher order cutaneous melanoma. Subjects were Ontario participants of the International Genes, Environment and Melanoma study and were diagnosed with either a single primary melanoma (SPM) [n=406], or a multiple primary melanoma (MPM) [n=125]. Multivariate unconditional logistic regression was applied. TE ever/never use adjusted for age, sex, skin colour, family history, and average annual hours and intermittency of sun exposure was associated with an odds ratio of 1.72 [1.02,2.77]. Participants first exposed prior to age 20 showed a significant 2.42-fold increase in risk compared to never users. Consistency of current findings with those of traditional case-control studies suggests that artificial UVR exposures, particularly in early life, are important in the development of first, as well as subsequent, melanomas.