OBJECTIVE: To investigate the diagnosis and treatment of melanomas of the central nervous system. METHODS: The clinical data, including presentation, treatment, operative finding, histological diagnosis and prognosis of 15 patients with melanomas of central nervous system who underwent surgery 1996 - 2003 were reviewed. RESULTS: There were 12 cases of intracranial melanoma and 3 cases of spinal cord melanomas. No distinctive symptoms occurred in these patients. Total resection was achieved in 5 cases, and subtotal resection in 10 cases. Histological examination showed melanoma in 10 cases, meningeal melanocytoma in 4 cases, and amelanotic melanoma in 1 case. Ten cases were followed up for 3 months to 9 years. Among the 10 cases only 1 survived. CONCLUSION: Melanoma of the central nervous system is an extremely rare tumor and difficult to get correct preoperative diagnosis. Microsurgery combined with radiotherapy or gamma-knife therapy is recommended. The prognosis is very poor.