BackgroundPrimary malignant melanoma of the female urethra is a rare pathology. Treatment options are still debated.CaseThe authors describe a patient with a primary malignant melanoma of the urethra 5.4 cm in diameter presenting as postmenopausal vaginal bleeding and treated with anterior pelvic exenteration. No adjuvant therapy was administered. The patient died of pneumonia shortly after discharge.DiscussionHistogenesis, diagnosis, therapy, and prognosis of malignant melanoma are discussed briefly.ConclusionSuccessful treatment of malignant melanomas of the urethra has been reported. These tumors should be treated aggressively. The role of adjuvant &agr;-interferon and chemotherapy is currently under investigation. Involvement of lymph nodes and depth of invasion are important prognostic factors.