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Despite its derivation from melanocytes, there are significant differences between mucosal melanomas and cutaneous melanomas. Namely, the non-specific symptoms, lack of known risk factors including sun exposure or family history, and very low incidence. These tumors are rarely suspected and patients may present with only vague or generalized symptoms. More common benign lesions such as melanosis or amalgam tattoos may be assumed if the patient has no other presenting symptoms. These lesions may be overlooked which leads to their frequent late stage of presentation, and at times even go undiagnosed. Here we present a case of mucosal melanoma of the inferior turbinate and its challenge in diagnosis and treatment.