Oral melanomas occur most often on the palate and gingiva with the maxillary arch affected 80% of the time. Melanosis may exist many years before a definitive biopsy. Long-standing lesions may ulcerate but lack rolled borders or induration, features commonly associated with squamous cell carcinoma. Melanoma that involves oral mucosa is rare with an extremely poor prognosis. Surgical management remains the preferred treatment in combination with chemotherapy. Irradiation therapy is used occasionally as a primary modality in the elderly and medically compromised patients. Lymph node dissection is not routinely practiced. The poor prognosis of oral melanomas requires that pigmented lesions of undetermined origin be routinely biopsied.