Primary mucosal melanoma of head and neck should be treated surgically with optional adjuvant radiotherapy according to several authors. We have treated unoperable nasopharyngeal melanoma with 3D teletherapy (70Gy/2Gy/7weeks) with boost from brachytherapy (9Gy/3Gy). Local control was achieved with acceptable acute and late toxicity (1-year follow-up), however, the patient died due to metastases to the central nervous system.