OBJECTIVE: To report a case of melanoma of the nasal septum in a patient treated at the Otolaryngology and Cervico-Facial Surgery at the Regional Hospital of Presidente Prudente in the period March to April of 2007. CASE REPORT: IT, 78 years old, male, coming from Presidente Prudente - SP, presented in the left nostril nose bleed spontaneously over a period of 07 days, small volume, with progressive worsening associated with nasal obstruction on the left. On examination, vascular lesions characteristic of a red wine stain, occupying the entire anterior region of the left nostril, absence of lymphadenopathy. Computerized tomography of the paranasal sinuses, poorly vascularized lesion contiguous with the left inferior turbinate and noninvasive occupying the left anterior nasal cavity. Biopsy of the lesion, Histopathological examination confirmed malignant melanoma of the nasal septum to the left. Lymphoscintigraphy was performed, with a positive lymph node on the right. The patient underwent tumor excision via degloving, with margins of safety associated with the operation of cervical lymph node on the right. In the fourth week after surgery was performed Fibronasolaryngoscopy, whose results showed no signs of nasal injury. The patient was followed up by the Department of Otolaryngology and Neck Surgery quarterly with imaging. After two years, the patient died from causes unrelated to melanoma. CONCLUSION: Melanoma of the nasal septum is a rare but potentially lethal affection. For the nonspecific symptoms should be evaluated with history and physical examination, coupled with additional imaging. The determination of early diagnosis is crucial for prognosis and treatment in pathology.