OBJECTIVE. The purpose of this article is to summarize the epidemiologic characteristics, clinical aspects, and radiologic appearance of as well as the management considerations and differential diagnoses for noncutaneous primary melanomas occurring at specific anatomic sites. Primary ocular, sinonasal, meningeal, biliary, adrenal, alimentary tract, and genitourinary melanomas are highlighted. CONCLUSION. Noncutaneous primary melanomas are a complex group of malignancies with biologic findings that are unique when compared with findings for cutaneous melanomas. Each noncutaneous primary melanoma has its own specific diagnostic and management challenges, depending on the anatomic location where they arise.