Purpose Naevus cell inclusions (NCI), also termed naevus cell rests, are aggregates of melanocytes in lymph node (LN) tissue. They represent arrested migration and trapping of neural crest cells in LN capsule and resemble the cells in cutaneous nevi. Modern utilisation of sentinel lymph node biopsy (SLNB) in management of malignant melanoma guides both prognostication and treatment, particularly in utilisation of novel targeted agents. Differentiation between NCI and metastatic melanoma can be challenging due to similar patterns in immunohistochemistry staining. Methodology A retrospective review was performed at our institution to review all SLNB completed for melanoma in the past 5 years (2018-2023). Cases of NCI were highlighted. Site of SLNB, disease stage and follow-up were analysed. Results Seventy-seven patients underwent SLNB in the study period totalling 129 collected lymph nodes. These included 35 in the axilla, 26 in the groin and 18 in the neck with 2 patients having nodes collected from multiple sites. Three patients were found to have NCIs, with all cell inclusions found within the lymph node capsule. The average Breslow Thickness of the patients with NCIs was 1.25mm and TNM tumour stage T2a. Patients with NCI were followed up for average 2.8 years without evidence of recurrence. Periodic nodal basin ultrasound was performed in 2 patients. Interestingly all cases of NCI were present in axillary lymph nodes. Conclusion The significance on NCI in melanoma SLNB in poorly understood. Our series shows no melanoma recurrence or spread in patient with NCI followed up for over 2.5 years. Nodal basin ultrasound is a safe and repeatable strategy to follow-up these patients.