Primary malignant melanoma of the vagina is rare but aggressive. Various treatment options include surgery and
adjuvant therapy has been advocated but the outcome remained unpredictable. Standard treatment protocol is yet to
be established. We report a case of 54-year-old, Para 4+1, with malignant melanoma of the vagina. She underwent
wide local excision but the surgical margin was not clear of malignant cells, hence adjuvant radiotherapy was given.
Combination chemotherapy was initiated subsequently as her disease disseminated. She succumbed later due to
septicaemic shock. The treatment options for vaginal melanoma were reviewed.