Objective: To report two cases of mucosal melanoma of the sinonasal cavity from India and review the literature emphasizing current important clinical and biologic aspects of this tumor. Methods: Design: Case Report Setting: Tertiary Public Referral Hospital Patients: Two Results: Two patients presenting with progressive unilateral nasal obstruction over three to six months, respectively, were diagnosed to have sinonasal mucosal melanoma. The mass involved the nasal cavity and maxillary antrum in both patients. The first patient deferred radiotherapy for four months until pulmonary metastasis became evident, necessitating palliative chemotherapy; the second patient underwent surgical excision and radiotherapy. Conclusion In spite of aggressive therapy, the prognosis for people with mucosal melanoma is extremely poor. Surgery remains the mainstay of treatment, although adjuvant radiation therapy has recently had an increasing role in the treatment of mucosal melanoma. A clear understanding of the pathophysiology of this disease may yield more specific immunotherapy and chemotherapy techniques. A multicenter prospective study is required to objectively assess the optimal treatment regimen.