The literature on mucosal melanoma of the head and neck is sparse, and an understanding of these melanomas requires extrapolating from experience with melanomas at other sites. Many exciting developments in the staging of melanomas with scintigraphic techniques may be applicable to melanomas of the head and neck. Blood tests may prove useful for monitoring patients after therapy. Surgery combined with radiation therapy is preferred for patients with localized disease. Despite improvements in surgical techniques, the survival of patients with mucosal melanoma is poor. Polychemotherapy and immunochemotherapy continue to show promise for the treatment of metastatic disease. Ultimately, the use of modified tumor vaccines may have the greatest potential for improving the outcome of patients with mucosal melanoma.