This report presents the case of long term survival of primary vaginal melanoma treated by local excision and vaginal brachytherapy. A unique histopathological pattern of preinvasive vaginal melanoma is also described. A review of the literature revealed 22 long term survivals after treatment of malignant melanoma of the vagina, and only 4 surviving more than 10 years. In general the prognosis in women with these malignancy is poor regardless of type of surgery. Depth of infiltration seems to be the only important prognostic factor influencing the survival.