AbstractForty‐two patients with mucosal melanoma of the head and neck were treated at the M. D. Anderson Cancer Center from 1944‐1989. Their records were evaluated regarding: location of the primary, stage of the disease at presentation, type of treatment, location of recurrences, and overall survival. These patients received the majority of their therapy at M. D. Anderson Cancer Center. The treatment consisted of surgery, radiotherapy, chemotherapy, immunotherapy, or a combination of these. The 5‐year survival rate was 40%. Twenty‐four of 27 patients who died with metastatic melanoma had local or regional disease concomitantly. Forty percent of patients were free of disease at 5 years; however, only 26% had long‐term survival. Although the majority of patients eventually succumbed to their disease, local and regional control was obtained initially in 92% of the group. These data indicate that prolonged survival is possible with mucosal melanoma of the head and neck; however, recurrence or metastasis remain possible many years after the initial