We reviewed our consultations and enucleations for suspected choroidal melanomas from 1954 through 1977. Among 876 eyes enucleated here during that period, 203 contained malignant melanomas; among these were 172 with melanomas of the choroid. Eighteen additional eyes contained melanomas of the anterior uvea. Six melanomas were clinically unsuspected. These unsuspected cases represented 2.6% of the 233 eyes in this series of enucleated eyes that were removed because of painful glaucoma, and 3.2% of the 190 uveal melanomas. Our study included eyes enucleated elsewhere after a clinical diagnosis of malignant melanoma was made here. Six of 224 eyes enucleated for clinically suspected melanoma were found to have mimicking lesions, a misdiagnosis rate of 2.7%. Two additional eyes were misdiagnosed as having simulating lesions before histologic confirmation of malignant melanoma after enucleation elsewhere.