目的　探讨女性尿道原发性恶性黑色素瘤的临床特征及治疗方法。方法　对4例女性原发性恶性黑色素瘤进行临床病理分析及随访观察。结果　4例患者均为尿道外口肿物就诊。2例因术前诊断不清,仅作局部切除,其中 1 例术后 16 个月死于肿瘤复发,1例仍在随访中;另2例行全尿道切除,双侧腹股沟淋巴结清扫及永久性膀胱造瘘。结论　女性尿道原发性黑色素瘤恶性度高,临床易误诊,早期诊断的主要依据是病理学探查,及时规范手术是提高患者生存率的主要方法。 Objective To investigate the clinical characteristics and treatment of female primary urethral malignant melanoma. Methods Four cases of primary malignant melanoma were observed clinically and pathologically. Results 4 patients were treated with urethral orifice. Two cases were diagnosed as unclear because of preoperative diagnosis, and only partial resection was performed. One case died of tumor recurrence 16 months after operation and one case was still under follow-up. The other two cases underwent total urethral resection, bilateral inguinal lymph node dissection and permanent Bladder fistula. Conclusions Female urethra primary melanoma has high malignant degree and is easily misdiagnosed. The main basis of early diagnosis is pathological examination, and timely standard operation is the main method to improve the survival rate of patients.