Nasal mucosal melanoma presents usually with epistaxis, nasal obstruction and facial pain. However melanoma tends to give distant metastases at an early stage, having rare clinical presentations.We present a 74-year old female patient with symptoms of central type vertigo caused by brain metastases. Clinical assessment for the detection of the primary site revealed a nasal mucosal melanoma originating from the posterior end of the left inferior turbinate. The patient received a combination of radio and chemotherapy being in relatively good condition 8 months later. This is the first reported case of a nasal mucosal melanoma with vertigo as the first presenting symptom.