Primary malignant melanoma of the nasal and paranasal sinuses is extremely rare in Korea, even occasional reports were found, mostly in western literature. The authers have recently experienced a case of primary malignant melanoma originated on the left ethmoid sinus. A 23 year-old Korean male soldier was admitted to the department of ophthalmology with chief complaints of visual disturbance, tearing, and eye ball pain. However, he was transferred to our department of otolaryngology because of identifying of the origin of the tumor to be left ethmoid sinus in C-T scan and we had biopsy at the left ethmoid region and cervical lymph node and the result was malignant melanoma. The patient was received Co⁶⁰ teletherapy and symptoms were subsided. The authors report here the patient's clinical course and brief review of the literature malignant melanoma originating on the left ethmoid sinus.