The location of melanoma in the oral cavity is extremely rare: its frequency varies between 0.2 and 8%. Oral melanoma strikes mainly male subjects and is more frequently seen at the level of the hard palate and gingiva. Today the clinicopathological classification of oral melanoma is not yet clearly outlined, and that is why the skin form is often taken as a reference. The acral lentiginous subtype proves to be the most common in this seat. In many cases (up to 50%) the diagnosis of melanoma is made on lesions which have evolved from the pre-existing pigmented lesions: as a consequence, every pigmented lesion of undetermined origin must be biopsied as a routine. The prognosis often proves poor and the surgical approach, combined with the chemotherapeutic one, is the first choice treatment. Lymph node dissection is not routinely practiced.