Malignant melanoma affecting the nasal cavity and paranasal sinuses is a rare condition with a poor prognosis. The Head and Neck Oncology Clinic at the University Hospital Nottingham has treated 16 patients in an 8-year-period. Twelve patients were treated with primary radical surgery and salvage radiotherapy was used for 7 patients with local recurrence. This resulted in tumour shrinkage in 4 patients. Eight patients treated surgically, have died of systemic spread. Four are currently alive, although 2 have local disease.