Mucosal melanoma in the region of head and neck is a rare and aggressive tumor. Diagnosis is usually late due to the quick, vertical spread of the disease, the a lack of early or specific signs and because of the location of lesions. The mainstay of treatment is radical surgical resection. The value of sentinel lymph node biopsy, lymphadenectomy and radiotherapy is still unclear. The objective of this study is to report five patients with primer malignant mucosal melanoma and briefly summarize the current literature of the etiology, staging and treatment of the disease.