In their heartland of Mukah, the Melanau have abandoned living in their traditional tall houses and now favour coastal kampung-style villages having adopted a Malay lifestyle.

The Melanau differ ethnically from the Sarawak Malays, but their dialects, which are distinct from Malay, do not differ sufficiently to constitute a barrier to communication. They are regarded as fine boat-builders and fishermen. Their economy is supplemented by padi, rubber and sago palm cultivation.

The original religion of the Melanau people was Liko, meaning "people of the river". In the Liko religion, life and the environment are one. Followers worship the spiritual world, including the superior tou spirits and the lesser belum spirits that cause sickness. The pagan Melanau use effigies of sickness spirits when practising healing. These effigies are called berbayah and berayun.

Many Melanau today are Christian and Muslim, though they still celebrate traditional animist festivals, most notably Kaul.