BACKGROUND Anorectal malignant melanoma (AMM), is a rare and aggressive form of melanoma. Accounts for <2% of melanomas, and <2% of anal tumors. It is more frequent at the 6th-7th decade, mostly in women. Surgery is the mainstay of treatment, but the extent is controversial. METHODS 82-year-old male, presented with rectal mass in the Emergency Room (ER). After local excision, pathology observed that the mass corresponded to AMM. Despite being stage I (Local disease), a year later it presented with local recurrence and distant metastasis. The patient died 32 months after diagnosis. CONCLUSIONS There is no optimal treatment, due to the lack of prospective studies. Wide local excision (WLE) has faster recovery, less post-operatory complications and similar survival rate compared to abdominal perineal resection (APR).