The initial clinical manifestation and subsequent pathologic characteristics of choroidal melanomas were reviewed in 20 enucleated eyes of Hispanic patients identified between 1974 and 1992. We compared them to 125 choroidal melanomas of randomly selected white patients identified over the same time period. At the time of diagnosis and at subsequent enucleation, the Hispanic patients were younger (P = .002) than the white patients. Eye pain (P = .016), red eye (P = .0002), and tearing (P = .012) were reported more commonly by the Hispanic patients, and on clinical examination the intraocular pressure was higher (P = .001) and more rubeosis iridis was noted (P < .0001) in the Hispanic patients than in the white patients. The tumors of the Hispanic patients were larger in their greatest base dimension (P = .003), and were heavily pigmented compared with those of the white patients (P = .0001). A trend toward less inflammation within the tumor and toward more epithelioid cell type was noted in the Hispanic patients.