Primary malignant melanoma of the vagina is a very rare, but very aggressive tumor. We describe a case of primary vaginal melanoma and review the literature. The patient, a 73-year-old, gravida 2, para 2 postmenopausal Greek woman, presented with abnormal vaginal bleeding for 30 days. On vaginal examination there was a 5.5 x 5 x 2 cm raised, ulcerated and irregular lesion on the posterior vaginal wall. Pathology examination of the entire specimen demonstrated a nodular vaginal melanoma. The histologic diagnosis was confirmed by positive immunostaining. The patient began postoperative immunotherapy with interferon-a2b. She died 25 months later because of cerebral metastases. In conclusion, the prognosis of vaginal melanoma is very poor, despite the treat­ment modality, because most cases are diagnosed at a late stage.